Individual provider Active NPI

Yaneidy Candelario, APRN

  • Nurse Practitioner
  • Lehigh Acres, FL
National Provider Identifier
1790467280
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11027879 Issued in FL
Practice address
2724 5TH St W # C
Lehigh Acres, FL 33971-1581
Phone
(239) 303-9296
NPI assigned
Aug 3, 2023
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11027879 FL Primary

Addresses

Primary practice location

2724 5TH St W # C
Lehigh Acres, FL 33971-1581

Mailing address

2724 5TH St W # C
Lehigh Acres, FL 33971-1581
Phone (239) 303-9296

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240219000274 FL Practitioner - Nurse Practitioner 8224472220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Healthcare Systems, IncGroup PAC ID 1951472885, 3 clinicians

Practice addresses (Care Compare)

2724 5TH St W
Suite B C
Lehigh Acres, FL 33971-1574
Phone (239) 303-9298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11027879FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Healthcare Systems, Inc CurrentSince Jan 30, 2024 Accepting new patients
Gulf Coast Healthcare Systems Inc CurrentSince Jan 30, 2024 Accepting new patients
Gulf Coast Healthcare Center, Inc. CurrentSince Apr 20, 2025 Accepting new patients
Coral Diagnostic Center Inc PastSince Aug 1, 2023 Accepting new patients

Locations

2724 5th St W
Ste B
Lehigh Acres, FL 33971
Phone (239) 303-9298

2724 5th St W
Ste Bc
Lehigh Acres, FL 33971
Phone (239) 303-9298

2724 5th St W
Ste C
Lehigh Acres, FL 33971
Phone (239) 303-9296

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1790467280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 5TH ST W # C",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711581",
            "telephone_number": "239-303-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 5TH ST W # C",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711581",
            "telephone_number": "239-303-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANDELARIO",
        "first_name": "YANEIDY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11027879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

Verify at the official NPI Registry.