Provider Demographics
NPI:1598379711
Name:YONG, YANICSI (APRN)
Entity Type:Individual
Prefix:
First Name:YANICSI
Middle Name:
Last Name:YONG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8175 NW 12TH ST STE 306
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1828
Mailing Address - Country:US
Mailing Address - Phone:305-575-3800
Mailing Address - Fax:305-470-5846
Practice Address - Street 1:1350 NW 14TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1609
Practice Address - Country:US
Practice Address - Phone:305-575-3800
Practice Address - Fax:305-470-5846
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9395450163W00000X
FLAPRN11004720363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse