Provider Demographics
NPI:1134606130
Name:CORDOVA PITA, YOHANYS (ARNP)
Entity type:Individual
Prefix:
First Name:YOHANYS
Middle Name:
Last Name:CORDOVA PITA
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 1:6671 W 22ND CT APT 9
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3954
Mailing Address - Country:US
Mailing Address - Phone:786-970-5427
Mailing Address - Fax:
Practice Address - Street 1:14001 NW 82ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1561
Practice Address - Country:US
Practice Address - Phone:786-609-9200
Practice Address - Fax:305-566-7699
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9339442363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner