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General NPI Number Information
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NPI Number | 1841230695
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Entity Type | Organization
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Legal Business Name | BASIL M YATES MD PA
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 590 E 25TH ST STE 601
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City | HIALEAH
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State | FL
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Zip | 33013-3841
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Country | US
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Telephone | 305-836-1940
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Fax | 305-693-0098
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Provider Business Mailing Address
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Address Line | 590 E 25TH ST STE 601
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City | HIALEAH
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State | FL
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Zip | 33013-3841
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Country | US
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Telephone | 305-836-1940
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Fax | 305-693-0098
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Authorized Official
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Title or Position | NURSE ADMINISTRATOR
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Name | KATHLEEN YATES
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Credential |
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Telephone | 305-836-1940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | ME0007781
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License Number State | FL
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