Provider Demographics
NPI:1265633846
Name:TAIT, YANURYS (LMT RCA)
Entity Type:Individual
Prefix:MS
First Name:YANURYS
Middle Name:
Last Name:TAIT
Suffix:
Gender:F
Credentials:LMT RCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7171 CORAL WAY STE 417
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1693
Mailing Address - Country:US
Mailing Address - Phone:305-266-7122
Mailing Address - Fax:305-266-7141
Practice Address - Street 1:7171 CORAL WAY STE 417
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1693
Practice Address - Country:US
Practice Address - Phone:305-266-7122
Practice Address - Fax:305-266-7141
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8380111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation