Healthcare Provider Details

I. General information

NPI: 1326403684
Provider Name (Legal Business Name): MAILENE YANES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2015
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 W 49TH ST STE 105
HIALEAH FL
33012-2948
US

IV. Provider business mailing address

13715 SW 32ND ST
MIAMI FL
33175-6650
US

V. Phone/Fax

Practice location:
  • Phone: 305-362-4382
  • Fax:
Mailing address:
  • Phone: 305-281-2677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME139645
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberACN914
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number19461
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: