Provider Demographics
NPI:1619440823
Name:MOREJON, YAGMARY (APRN)
Entity Type:Individual
Prefix:MS
First Name:YAGMARY
Middle Name:
Last Name:MOREJON
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 1:655 N MILITARY TRL STE 9
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-1305
Mailing Address - Country:US
Mailing Address - Phone:561-686-0120
Mailing Address - Fax:561-686-0120
Practice Address - Street 1:655 N MILITARY TRL STE 7
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-1305
Practice Address - Country:US
Practice Address - Phone:561-686-0120
Practice Address - Fax:561-686-0120
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP2300X
FLAPRN11000379363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care