Provider Demographics
NPI:1720555121
Name:PLACENCIA GONZALEZ, YULEIMA (APRN)
Entity Type:Individual
Prefix:
First Name:YULEIMA
Middle Name:
Last Name:PLACENCIA GONZALEZ
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 1:3905 NW 107TH AVE STE 409
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2785
Mailing Address - Country:US
Mailing Address - Phone:786-953-1774
Mailing Address - Fax:689-303-3268
Practice Address - Street 1:3905 NW 107TH AVE STE 409
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2785
Practice Address - Country:US
Practice Address - Phone:786-953-1774
Practice Address - Fax:689-303-3268
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9454691363LA2200X, 363LW0102X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health