Provider Demographics
NPI:1548808744
Name:ALONSO, YAIMY (ARNP)
Entity type:Individual
Prefix:
First Name:YAIMY
Middle Name:
Last Name:ALONSO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:YAIMY
Other - Middle Name:
Other - Last Name:ALONSO MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:842 SUNSET LAKE BLVD STE 403
Mailing Address - Street 2:BUILDING B
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-7553
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:842 SUNSET LAKE BLVD STE 403
Practice Address - Street 2:BUILDING B
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-7553
Practice Address - Country:US
Practice Address - Phone:941-485-3351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-18
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005444207R00000X
FLAPRN11005444363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine