Provider Demographics
NPI:1255106274
Name:YANES ANGEL, EDITH CECILIA I (RN)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:CECILIA
Last Name:YANES ANGEL
Suffix:I
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8591 NW S RIVER DR
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7426
Mailing Address - Country:US
Mailing Address - Phone:305-456-3000
Mailing Address - Fax:305-631-2180
Practice Address - Street 1:8591 NW S RIVER DR
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33166-7426
Practice Address - Country:US
Practice Address - Phone:305-456-3000
Practice Address - Fax:305-631-2180
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9502655163WM0102X, 163W00000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty