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General NPI Number Information
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NPI Number | 1194830109
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Entity Type | Organization
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Legal Business Name | YIRA DE LA PAZ MD PA
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 500 N HIATUS RD STE 103
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-5213
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Country | US
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Telephone | 954-443-4423
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Fax | 954-443-4483
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Provider Business Mailing Address
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Address Line | PO BOX 820897
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City | SOUTH FLORIDA
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State | FL
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Zip | 33082-0897
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Country | US
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Telephone | 954-443-4423
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Fax | 954-443-4483
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Authorized Official
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Title or Position | PRESIDENT
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Name | YIRA L DE LA PAZ,
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Credential | MD
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Telephone | 954-443-4423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME89466
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License Number State | FL
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