Provider Demographics
NPI:1598357113
Name:MENENDEZ RODRIGUEZ, YANNIA
Entity Type:Individual
Prefix:
First Name:YANNIA
Middle Name:
Last Name:MENENDEZ RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14970 SW 48TH TER APT H
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4222
Mailing Address - Country:US
Mailing Address - Phone:786-389-7260
Mailing Address - Fax:
Practice Address - Street 1:14970 SW 48TH TER APT H
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4222
Practice Address - Country:US
Practice Address - Phone:786-389-7260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009732363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily