Individual provider Active NPI

Yahima Llanes Canadilla

  • Family Nurse Practitioner
  • Pinellas Park, FL
National Provider Identifier
1952169799
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11031092 Issued in FL
Practice address
9221 55TH St N
Pinellas Park, FL 33782-5106
Phone
(502) 656-0340
NPI assigned
Mar 7, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 11031092 FL Primary

Addresses

Primary practice location

9221 55TH St N
Pinellas Park, FL 33782-5106

Mailing address

9221 55TH St N
Pinellas Park, FL 33782-5106
Phone (502) 656-0340

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
I20240702004551 FL Practitioner - Nurse Practitioner 8224572136 Reassigns benefits to 2 organizations

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
Nova Medical Services - Wound Care Division LLCGroup PAC ID 6709280324, 35 clinicians

Practice addresses (Care Compare)

8260 W Flager St
Suite 2I
Miami, FL 33144-2069
Phone (786) 715-9183

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11031092FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Medical Services - Wound Care Division LLC Single Specialty CurrentSince May 8, 2024 Accepting new patients
Nova Medical Services - Dermatology Division LLC Single Specialty CurrentSince May 7, 2024 Accepting new patients

Locations

8260 W Flagler St
Ste 2I
West Miami, FL 33144
Phone (786) 530-6272

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": "1709769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1952169799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9221 55TH ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337825106",
            "telephone_number": "502-656-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9221 55TH ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337825106",
            "telephone_number": "502-656-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLANES CANADILLA",
        "first_name": "YAHIMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-03-07",
        "certification_date": "2024-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11031092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

Verify at the official NPI Registry.