Provider Demographics
NPI:1346744166
Name:DUCONGE MUNARRIZ, YEISELL (MD)
Entity Type:Individual
Prefix:
First Name:YEISELL
Middle Name:
Last Name:DUCONGE MUNARRIZ
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 1:1890 SW 57TH AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2164
Mailing Address - Country:US
Mailing Address - Phone:786-536-1701
Mailing Address - Fax:305-847-2447
Practice Address - Street 1:5901 SW 74TH ST STE 408
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5164
Practice Address - Country:US
Practice Address - Phone:305-735-3555
Practice Address - Fax:954-990-7650
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1510532084P0804X, 2084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program