Healthcare Provider Details

I. General information

NPI: 1861086431
Provider Name (Legal Business Name): YIN & YANG REJUVENATION, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2021
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6741 SW 24TH ST STE 42
MIAMI FL
33155-1767
US

IV. Provider business mailing address

6741 SW 24TH ST STE 42
MIAMI FL
33155-1767
US

V. Phone/Fax

Practice location:
  • Phone: 305-842-4447
  • Fax:
Mailing address:
  • Phone: 786-644-5691
  • Fax: 786-980-2430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YOULYS VENTO
Title or Position: OWNER
Credential:
Phone: 786-644-5691