Provider Demographics
NPI:1740963495
Name:YONG, YENLYS (ADVANCED REGISTERED)
Entity type:Individual
Prefix:
First Name:YENLYS
Middle Name:
Last Name:YONG
Suffix:
Gender:F
Credentials:ADVANCED REGISTERED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 W 68TH ST APT H204
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4408
Mailing Address - Country:US
Mailing Address - Phone:786-306-0302
Mailing Address - Fax:
Practice Address - Street 1:1900 W 68TH ST APT H204
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4408
Practice Address - Country:US
Practice Address - Phone:786-306-0302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11027180363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner