Provider Demographics
NPI:1366269250
Name:BAEZ, YAZAIRA (RN, MSN)
Entity type:Individual
Prefix:
First Name:YAZAIRA
Middle Name:
Last Name:BAEZ
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CASTELLANA GARDENS
Mailing Address - Street 2:32 EE1
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983
Mailing Address - Country:US
Mailing Address - Phone:787-237-0235
Mailing Address - Fax:
Practice Address - Street 1:CASTELLANA GARDENS 32 EE1
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-237-0235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3613163WG0600X, 363L00000X
PR3513364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner