Lissette Maria Yanez-Cosculluela, MSN, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11019936 Issued in FL

Practice address

15920 W Prestwick PL
Miami Lakes, FL 33014-6526

Phone

(305) 216-1867

NPI assigned

Jun 12, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IJFBDD/Endpoint/IJFBDD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1487384640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15920 W PRESTWICK PL",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330146526",
            "telephone_number": "305-216-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15920 W PRESTWICK PL",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330146526",
            "telephone_number": "305-216-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANEZ-COSCULLUELA",
        "first_name": "LISSETTE",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-12",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11019936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Yjm Mega Medical Supply, Corp
• Ymt Behavior Services LLC
• Ynav Medical Center Corp

• Family Nurse Practitioner in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.