=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811586837
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YJW EXCELLENT CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/14/2021
-----------------------------------------------------
Last Update Date | 08/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13205 SW 137TH AVE STE 126
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33186-5334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-713-0383
-----------------------------------------------------
Fax | 786-250-5397
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13205 SW 137TH AVE STE 126
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33186-5334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-713-0383
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | YOSLEIDY GARCIA RODRIGUEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-619-7677
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------