Provider Demographics
NPI:1295909976
Name:FAJARDO AQUINO, YOVANIT (DNM, FNP-BC, ARNP)
Entity type:Individual
Prefix:
First Name:YOVANIT
Middle Name:
Last Name:FAJARDO AQUINO
Suffix:
Gender:M
Credentials:DNM, FNP-BC, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6880 TAMIAMI CANAL RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4451
Mailing Address - Country:US
Mailing Address - Phone:786-326-7504
Mailing Address - Fax:350-235-3742
Practice Address - Street 1:1502 NW 4TH ST STE 5
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4854
Practice Address - Country:US
Practice Address - Phone:305-569-4060
Practice Address - Fax:305-646-6757
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLARNP9339362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0129834-00Medicaid