Provider Demographics
NPI:1679324784
Name:IGARZA OCONOR, YOANDRIS (APRN)
Entity type:Individual
Prefix:DR
First Name:YOANDRIS
Middle Name:
Last Name:IGARZA OCONOR
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 DIPLOMAT PKWY E
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-5221
Mailing Address - Country:US
Mailing Address - Phone:786-291-3576
Mailing Address - Fax:
Practice Address - Street 1:346 DIPLOMAT PKWY E
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-5221
Practice Address - Country:US
Practice Address - Phone:786-291-3576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11031733363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner