Individual provider Active NPI

Yesenia D Villalta, ARNP

  • Women's Health Nurse Practitioner
  • Doral, FL
National Provider Identifier
1609974351
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
3421002 Issued in FL
Practice address
8175 NW 12TH St
Suite 306
Doral, FL 33126-1828
Phone
(786) 845-0173
Fax
(305) 845-0306
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 3421002 FL Primary

Addresses

Primary practice location

8175 NW 12TH St
Suite 306
Doral, FL 33126-1828

Mailing address

8175 NW 12TH St
Suite 306
Doral, FL 33126-1828
Phone (786) 845-0173

Other identifiers 1

IdentifierTypeStateIssuer
307046800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3421002FLMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health PastSince Feb 14, 2021 Accepting new patients
Florida Department of Health Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1609974351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 NW 12TH ST",
            "address_2": "SUITE 306",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261828",
            "telephone_number": "786-845-0173",
            "fax_number": "305-845-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 NW 12TH ST",
            "address_2": "SUITE 306",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261828",
            "telephone_number": "786-845-0173",
            "fax_number": "305-845-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALTA",
        "first_name": "YESENIA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "3421002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307046800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.