Provider Demographics
NPI:1477163665
Name:MARTINEZ SOTO, YODANY (APRN)
Entity Type:Individual
Prefix:
First Name:YODANY
Middle Name:
Last Name:MARTINEZ SOTO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11245 SW 227TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-3511
Mailing Address - Country:US
Mailing Address - Phone:786-641-9212
Mailing Address - Fax:
Practice Address - Street 1:11245 SW 227TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-3511
Practice Address - Country:US
Practice Address - Phone:786-641-9212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008394363LF0000X
FL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No104100000XBehavioral Health & Social Service ProvidersSocial Worker