Provider Demographics
NPI:1669369955
Name:REYES VALDEZ, YANET (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:REYES VALDEZ
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 LAKE POINTE DRIVE
Mailing Address - Street 2:UNIT 211
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309
Mailing Address - Country:US
Mailing Address - Phone:954-955-7193
Mailing Address - Fax:
Practice Address - Street 1:214 LAKE POINTE DRIVE
Practice Address - Street 2:UNIT 211
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309
Practice Address - Country:US
Practice Address - Phone:954-955-7193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-20
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001640363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant