Provider Demographics
NPI:1184319246
Name:RODRIGUEZ, YAMIRA
Entity type:Individual
Prefix:
First Name:YAMIRA
Middle Name:
Last Name:RODRIGUEZ
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 1:465 S ROYAL POINCIANA BLVD APT 11A
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7250
Mailing Address - Country:US
Mailing Address - Phone:305-721-0806
Mailing Address - Fax:
Practice Address - Street 1:465 S ROYAL POINCIANA BLVD APT 11A
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-7250
Practice Address - Country:US
Practice Address - Phone:786-514-9074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF03230781363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily