Provider Demographics
NPI:1326400011
Name:PAEZ, YANISLEIDY (MD, MPH)
Entity Type:Individual
Prefix:
First Name:YANISLEIDY
Middle Name:
Last Name:PAEZ
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:MISS
Other - First Name:YANISLEIDY
Other - Middle Name:
Other - Last Name:PAEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:415 E WASHINGTON ST
Mailing Address - Street 2:312
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-5524
Mailing Address - Country:US
Mailing Address - Phone:305-300-8489
Mailing Address - Fax:
Practice Address - Street 1:1540 E MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-0100
Practice Address - Country:US
Practice Address - Phone:877-475-6688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
FLME149098207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program