Healthcare Provider Details

I. General information

NPI: 1962499426
Provider Name (Legal Business Name): SUJATA YAVAGAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUJATA MULYE M.D.

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 N KENDALL DR STE 706E
MIAMI FL
33176-2150
US

IV. Provider business mailing address

8940 N KENDALL DR STE 701E
MIAMI FL
33176-2100
US

V. Phone/Fax

Practice location:
  • Phone: 786-534-8884
  • Fax: 786-534-8845
Mailing address:
  • Phone: 786-534-8884
  • Fax: 786-534-8845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberME101073
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME101073
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number002329
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: