Healthcare Provider Details

I. General information

NPI: 1689437634
Provider Name (Legal Business Name): YESHUA MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13255 SW 137TH AVE STE 109
MIAMI FL
33186-5327
US

IV. Provider business mailing address

13255 SW 137TH AVE STE 109
MIAMI FL
33186-5327
US

V. Phone/Fax

Practice location:
  • Phone: 786-877-1646
  • Fax: 786-250-4129
Mailing address:
  • Phone: 786-250-4145
  • Fax: 786-250-4129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YANET PEREZ PRIETO
Title or Position: PARTNER
Credential:
Phone: 786-877-1646