Provider Demographics
NPI:1508481847
Name:PLUESS, YAJAIRA P
Entity type:Individual
Prefix:
First Name:YAJAIRA
Middle Name:P
Last Name:PLUESS
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 1:8711 EXPOSITION DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2919
Mailing Address - Country:US
Mailing Address - Phone:608-421-2649
Mailing Address - Fax:
Practice Address - Street 1:8711 EXPOSITION DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-2919
Practice Address - Country:US
Practice Address - Phone:084-212-6496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7255133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered