Provider Demographics
NPI:1760262018
Name:YESENIA ENTERPRISES, LLC
Entity Type:Organization
Organization Name:YESENIA ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEJEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-735-3707
Mailing Address - Street 1:12094 ANDERSON RD # 122
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-5682
Mailing Address - Country:US
Mailing Address - Phone:813-735-3707
Mailing Address - Fax:
Practice Address - Street 1:8900 N ARMENIA AVE STE 216
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-1072
Practice Address - Country:US
Practice Address - Phone:813-735-3707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service