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General NPI Number Information
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NPI Number | 1689661217
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Entity Type | Individual
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Provider Name | DILEEP RAJHAVENDRA YAVAGAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 1150 NW 14TH ST STE 609
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City | MIAMI
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State | FL
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Zip | 33136-2117
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Country | US
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Telephone | 305-355-1103
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Fax | 305-355-1102
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Provider Business Mailing Address
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Address Line | 1120 NW 14TH ST FL 13
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City | MIAMI
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State | FL
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Zip | 33136-2107
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Country | US
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Telephone | 305-355-1103
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Fax | 305-355-1102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | ME100624
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME100624
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License Number State | FL
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