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General NPI Number Information
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NPI Number | 1710452446
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Entity Type | Organization
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Legal Business Name | ENERGY YOGA & WELLNESS LLC
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Dates
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Enumeration Date | 10/09/2018
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Last Update Date | 10/09/2018
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Provider Practice Location Address
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Address Line | 11402 NW 41ST ST STE 225
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City | DORAL
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State | FL
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Zip | 33178-4859
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Country | US
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Telephone | 305-486-3270
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Fax |
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Provider Business Mailing Address
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Address Line | 5440 NW 104TH CT
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City | DORAL
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State | FL
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Zip | 33178-2684
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Country | US
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Telephone | 305-562-7051
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID YGLESIAS
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Credential | RYT500E
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Telephone | 305-562-7051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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