Active NPI
Yesenia D Villalta, ARNP
- Women's Health Nurse Practitioner
- Doral, FL
National Provider Identifier
1609974351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 3421002
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 307046800 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3421002 | FL | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Department of Health | Past | 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.
-
- Public Health or Welfare Agency
- Quincy, FL
- NPI 1346446895
-
- Public Health or Welfare Agency
- Doral, FL
- NPI 1720171895
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.