Healthcare Provider Details

I. General information

NPI: 1669361440
Provider Name (Legal Business Name): YULIA RODE P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2025
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 N BAYSHORE DR APT 1909
MIAMI FL
33137-5465
US

IV. Provider business mailing address

2150 N BAYSHORE DR APT 1909
MIAMI FL
33137-5465
US

V. Phone/Fax

Practice location:
  • Phone: 754-736-6481
  • Fax:
Mailing address:
  • Phone: 754-736-6481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number2728-P.A.
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTPPA1222
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number24-539
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2728-P.A.
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: