Provider Demographics
NPI:1265839781
Name:HERNANDEZ, YAMILE (MD)
Entity Type:Individual
Prefix:
First Name:YAMILE
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 SW 74TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5300
Mailing Address - Country:US
Mailing Address - Phone:305-266-2929
Mailing Address - Fax:
Practice Address - Street 1:1149 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4758
Practice Address - Country:US
Practice Address - Phone:305-266-2929
Practice Address - Fax:786-453-7114
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-26
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18958208D00000X
FLACN803208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice