Provider Demographics
NPI:1235352477
Name:BARGE, YAMILLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:YAMILLE
Middle Name:
Last Name:BARGE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5444 NW 111TH CT
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3901
Mailing Address - Country:US
Mailing Address - Phone:305-599-0152
Mailing Address - Fax:
Practice Address - Street 1:7700 SW 104 ST
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156
Practice Address - Country:US
Practice Address - Phone:305-279-7546
Practice Address - Fax:305-279-7546
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9100982363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical