Provider Demographics
NPI:1356919773
Name:GUTIERREZ VERGEL, YENISLEN (APRN)
Entity type:Individual
Prefix:
First Name:YENISLEN
Middle Name:
Last Name:GUTIERREZ VERGEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 S CONGRESS AVE STE 1E
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7671
Mailing Address - Country:US
Mailing Address - Phone:407-485-2182
Mailing Address - Fax:
Practice Address - Street 1:1800 N DOUGLAS RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3200
Practice Address - Country:US
Practice Address - Phone:305-204-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-13
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9428518163W00000X
FLAPRN11010152363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse