Provider Demographics
NPI:1659546208
Name:YGJO MEDICAL CENTER, CORP
Entity Type:Organization
Organization Name:YGJO MEDICAL CENTER, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:YAZMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GONCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-805-0845
Mailing Address - Street 1:8 LINDSEY CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5222
Mailing Address - Country:US
Mailing Address - Phone:305-805-0845
Mailing Address - Fax:305-805-4405
Practice Address - Street 1:8 LINDSEY CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5222
Practice Address - Country:US
Practice Address - Phone:305-805-0845
Practice Address - Fax:305-805-4405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM19014225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMM19014OtherCHIROPRACTOR SERVICES, PHYSICAL THERAPY