Provider Demographics
NPI:1043053200
Name:RUSSINYOL JAIME, YULEIDY (APRN)
Entity type:Individual
Prefix:
First Name:YULEIDY
Middle Name:
Last Name:RUSSINYOL JAIME
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3833
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:2626 TAMPA RD STE 104
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3110
Practice Address - Country:US
Practice Address - Phone:727-781-5811
Practice Address - Fax:727-781-5613
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11033444363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily