Healthcare Provider Details

I. General information

NPI: 1295579761
Provider Name (Legal Business Name): YONATHAN JOSEPH DELOUYA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 07/22/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12 AVENUE ANESTHESIOLOGY DEPARTMENT, C-301
MIAMI FL
33136
US

IV. Provider business mailing address

9387 EAST BAY HARBOR DRIVE APT 303 S
BAY HARBOR ISLANDS FL
33154
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-6970
  • Fax: 305-545-6501
Mailing address:
  • Phone: 645-200-2632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: