Provider Demographics
NPI:1689275349
Name:COSTE JIMENEZ, YDALINA INMACULADA (ARNP)
Entity type:Individual
Prefix:
First Name:YDALINA
Middle Name:INMACULADA
Last Name:COSTE JIMENEZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 10TH CT STE 200B
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5013
Mailing Address - Country:US
Mailing Address - Phone:772-563-4673
Mailing Address - Fax:
Practice Address - Street 1:3555 10TH CT STE 200B
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5013
Practice Address - Country:US
Practice Address - Phone:725-634-6737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-07
Last Update Date:2025-05-22
Deactivation Date:2021-02-10
Deactivation Code:
Reactivation Date:2024-02-20
Provider Licenses
StateLicense IDTaxonomies
WI20-435246ZC0007X
FL11030383363L00000X, 363LF0000X
NC5021258363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner