Provider Demographics
NPI:1245906783
Name:AGUILERA HERRERA, YENILU K
Entity type:Individual
Prefix:
First Name:YENILU
Middle Name:K
Last Name:AGUILERA HERRERA
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 1:1440 E EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-6118
Mailing Address - Country:US
Mailing Address - Phone:386-748-0867
Mailing Address - Fax:407-598-6066
Practice Address - Street 1:1440 E EUCLID AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-6118
Practice Address - Country:US
Practice Address - Phone:386-748-0867
Practice Address - Fax:407-598-6066
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty