Provider Demographics
NPI:1750861464
Name:ACUNA VERDECIA, YANELIS (ARNP)
Entity Type:Individual
Prefix:
First Name:YANELIS
Middle Name:
Last Name:ACUNA VERDECIA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 NE 169TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-2916
Mailing Address - Country:US
Mailing Address - Phone:717-278-6290
Mailing Address - Fax:
Practice Address - Street 1:1585 NE 169TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-2916
Practice Address - Country:US
Practice Address - Phone:717-278-6290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9429736363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health