MEDICARE: YEISELL DUCONGE MUNARRIZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	ME151053	FL
2	2084P0804X	Child & Adolescent Psychiatry Physician	ME151053	FL
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1346744166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YEISELL DUCONGE MUNARRIZ MD

Provider Business Mailing Address
First Line	:	2450 SW 137TH AVE STE 205
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6312
Country	:	US
Telephone Number	:	305-537-9635
Fax Number	:	786-840-1393

Provider Business Practice Location Address
First Line	:	2450 SW 137TH AVE STE 205
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6312
Country	:	US
Telephone Number	:	305-537-9635
Fax Number	:	786-840-1393

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2018
Last Update Date	:	02/18/2026

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