Provider Demographics
NPI:1215368469
Name:YAMILE B PORRO
Entity Type:Organization
Organization Name:YAMILE B PORRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YAMILE
Authorized Official - Middle Name:B
Authorized Official - Last Name:PORRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-310-7530
Mailing Address - Street 1:3970 W FLAGLER ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1642
Mailing Address - Country:US
Mailing Address - Phone:786-310-7530
Mailing Address - Fax:786-452-0203
Practice Address - Street 1:3970 W FLAGLER ST STE 101
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1642
Practice Address - Country:US
Practice Address - Phone:786-310-7530
Practice Address - Fax:786-452-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83959208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME83959OtherMEDICAL LIC