Healthcare Provider Details

I. General information

NPI: 1528025079
Provider Name (Legal Business Name): NELLY LEAH YEFET A.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21402 W DIXIE HWY
AVENTURA FL
33180-1144
US

IV. Provider business mailing address

21402 W DIXIE HWY
AVENTURA FL
33180-1144
US

V. Phone/Fax

Practice location:
  • Phone: 305-933-2360
  • Fax: 305-933-5727
Mailing address:
  • Phone: 305-933-2360
  • Fax: 305-933-5727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP 963
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: