Provider Demographics
NPI:1427017193
Name:FERNANDEZ ESTEVES, YANIRA (MD)
Entity Type:Individual
Prefix:
First Name:YANIRA
Middle Name:
Last Name:FERNANDEZ ESTEVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 617
Mailing Address - Street 2:267 SIERRA MORENA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5583
Mailing Address - Country:US
Mailing Address - Phone:787-790-8249
Mailing Address - Fax:787-720-7371
Practice Address - Street 1:ROMANY GARDENS
Practice Address - Street 2:A-2 SANTA ROSA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-790-8249
Practice Address - Fax:787-720-7371
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11705207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7250159OtherHUMANA
PR87646OtherTRIPLE S, INC
PR87646Medicare ID - Type Unspecified