Healthcare Provider Details

I. General information

NPI: 1477057602
Provider Name (Legal Business Name): YESENIA KUAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 08/15/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 MADRUGA AVE STE 302
CORAL GABLES FL
33146-3164
US

IV. Provider business mailing address

1450 MADRUGA AVE STE 302
CORAL GABLES FL
33146-3164
US

V. Phone/Fax

Practice location:
  • Phone: 786-408-4636
  • Fax: 380-203-1277
Mailing address:
  • Phone: 305-766-2909
  • Fax: 380-203-1277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME152339
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: