Healthcare Provider Details

I. General information

NPI: 1639300304
Provider Name (Legal Business Name): YANEICY GONZALEZ ROJAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 01/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 W FLAGLER ST
CORAL GABLES FL
33134-1608
US

IV. Provider business mailing address

3900 W FLAGLER ST
CORAL GABLES FL
33134-1608
US

V. Phone/Fax

Practice location:
  • Phone: 305-702-0024
  • Fax: 305-702-0024
Mailing address:
  • Phone: 305-702-0024
  • Fax: 305-702-0024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME118820
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME118820
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: