Provider Demographics
NPI:1548852411
Name:MOLINA GUERRA, YENNIFER LORENA (APRN)
Entity type:Individual
Prefix:
First Name:YENNIFER
Middle Name:LORENA
Last Name:MOLINA GUERRA
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 1:519-A EAST BLOOMINGDALE AVE.
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511
Mailing Address - Country:US
Mailing Address - Phone:813-655-4100
Mailing Address - Fax:813-655-1775
Practice Address - Street 1:515 S KINGS AVE # 3100
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6060
Practice Address - Country:US
Practice Address - Phone:813-681-9171
Practice Address - Fax:813-681-7580
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011468363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health