Provider Demographics
NPI:1821759242
Name:ENRIQUEZ, YANET (APRN)
Entity Type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:ENRIQUEZ
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 1:1755 W 60TH ST APT D203
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6857
Mailing Address - Country:US
Mailing Address - Phone:305-495-7919
Mailing Address - Fax:
Practice Address - Street 1:10000 W SAMPLE RD STE A
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3936
Practice Address - Country:US
Practice Address - Phone:954-861-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11015963363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty