Provider Demographics
NPI:1457832156
Name:VELAZQUEZ MARICHAL, YANET (ARNP)
Entity Type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:VELAZQUEZ MARICHAL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17181 SW 91ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-4944
Mailing Address - Country:US
Mailing Address - Phone:786-299-8745
Mailing Address - Fax:
Practice Address - Street 1:18610 NW 87TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3518
Practice Address - Country:US
Practice Address - Phone:786-301-6725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9356070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily