Provider Demographics
NPI:1447969399
Name:GARCIA JARDINES, YOLAINE DE LOS ANGELES
Entity type:Individual
Prefix:DR
First Name:YOLAINE
Middle Name:DE LOS ANGELES
Last Name:GARCIA JARDINES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N DEAN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-3710
Mailing Address - Country:US
Mailing Address - Phone:407-384-7388
Mailing Address - Fax:
Practice Address - Street 1:100 N. DEAN ROAD, SUITE 101
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4896
Practice Address - Country:US
Practice Address - Phone:407-384-7388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-18
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022912363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty