Provider Demographics
NPI:1518773936
Name:MULET VELAZQUEZ, YAMILE (APRN)
Entity type:Individual
Prefix:
First Name:YAMILE
Middle Name:
Last Name:MULET VELAZQUEZ
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 CORDGRASS WAY
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2715
Mailing Address - Country:US
Mailing Address - Phone:561-502-7692
Mailing Address - Fax:
Practice Address - Street 1:2407 US HIGHWAY 98 N
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-2410
Practice Address - Country:US
Practice Address - Phone:407-930-1112
Practice Address - Fax:877-671-1402
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11036740363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner