Healthcare Provider Details

I. General information

NPI: 1124080163
Provider Name (Legal Business Name): YAMILE B PORRO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 08/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8260 W FLAGLER ST SUITE 2-M
MIAMI FL
33144-2069
US

IV. Provider business mailing address

8260 W FLAGLER ST SUITE 2-M
MIAMI FL
33144-2069
US

V. Phone/Fax

Practice location:
  • Phone: 305-559-4599
  • Fax: 305-559-4598
Mailing address:
  • Phone: 305-559-4599
  • Fax: 305-559-4598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME0083959
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: