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General NPI Number Information
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NPI Number | 1215368469
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Entity Type | Organization
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Legal Business Name | YAMILE B PORRO
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 3970 W FLAGLER ST STE 101
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City | CORAL GABLES
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State | FL
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Zip | 33134-1642
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Country | US
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Telephone | 786-310-7530
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Fax | 786-452-0203
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Provider Business Mailing Address
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Address Line | 3970 W FLAGLER ST STE 101
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City | CORAL GABLES
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State | FL
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Zip | 33134-1642
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Country | US
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Telephone | 786-310-7530
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Fax | 786-452-0203
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | YAMILE B PORRO
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Credential | MD
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Telephone | 786-310-7530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME83959
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License Number State | FL
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