Provider Demographics
NPI:1730958620
Name:GUERRA HERNANDEZ, YUSIMIGS (FNP)
Entity type:Individual
Prefix:
First Name:YUSIMIGS
Middle Name:
Last Name:GUERRA HERNANDEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11532 SW 142ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7007
Mailing Address - Country:US
Mailing Address - Phone:305-338-7807
Mailing Address - Fax:
Practice Address - Street 1:6600 COW PEN RD STE 300
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-7619
Practice Address - Country:US
Practice Address - Phone:786-953-5506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11028823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily