Healthcare Provider Details
I. General information
NPI: 1932923851
Provider Name (Legal Business Name): K & Y MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2024
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8950 SW 74TH CT STE 2201A3
MIAMI FL
33156-3171
US
IV. Provider business mailing address
8950 SW 74TH CT STE 2201A3
MIAMI FL
33156-3171
US
V. Phone/Fax
- Phone: 786-889-2345
- Fax: 786-796-1092
- Phone: 786-889-2345
- Fax: 786-796-1092
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YANISA
D
CASTILLO ALVAREZ
Title or Position: OWNER
Credential: APRN
Phone: 786-889-2345