Provider Demographics
NPI:1740747369
Name:PRADO, YULIEN
Entity Type:Individual
Prefix:
First Name:YULIEN
Middle Name:
Last Name:PRADO
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 1:9310 FONTAINEBLEAU BLVD APT 315
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4252
Mailing Address - Country:US
Mailing Address - Phone:786-366-3988
Mailing Address - Fax:
Practice Address - Street 1:9310 FONTAINEBLEAU BLVD APT 315
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4252
Practice Address - Country:US
Practice Address - Phone:786-366-3988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11000756363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner