Provider Demographics
NPI:1497392039
Name:MONDEJA, YANISLEIDY (FNP-C,PMHNP-BC,DNP)
Entity type:Individual
Prefix:DR
First Name:YANISLEIDY
Middle Name:
Last Name:MONDEJA
Suffix:
Gender:F
Credentials:FNP-C,PMHNP-BC,DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9835 SUNSET DR STE 105
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4648
Mailing Address - Country:US
Mailing Address - Phone:786-937-9835
Mailing Address - Fax:786-937-9834
Practice Address - Street 1:9835 SUNSET DR STE 105
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4648
Practice Address - Country:US
Practice Address - Phone:786-937-9835
Practice Address - Fax:786-937-9834
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-02
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005168363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty