Provider Demographics
NPI:1336813286
Name:CHERAZAR, YVENADINE (FNP)
Entity Type:Individual
Prefix:
First Name:YVENADINE
Middle Name:
Last Name:CHERAZAR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 HORNLAKE CIR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-8400
Mailing Address - Country:US
Mailing Address - Phone:407-435-0416
Mailing Address - Fax:
Practice Address - Street 1:2616 HORNLAKE CIR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-8400
Practice Address - Country:US
Practice Address - Phone:407-435-0416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily