Provider Demographics
NPI:1245887017
Name:FIALLO LLEDIAS, YILIAN (APRN)
Entity type:Individual
Prefix:
First Name:YILIAN
Middle Name:
Last Name:FIALLO LLEDIAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8840 SW 43RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5328
Mailing Address - Country:US
Mailing Address - Phone:786-468-6878
Mailing Address - Fax:305-594-0088
Practice Address - Street 1:1470 NW 107TH AVE STE G
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:FL
Practice Address - Zip Code:33172-2734
Practice Address - Country:US
Practice Address - Phone:305-594-8666
Practice Address - Fax:305-594-0088
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11003852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily