Provider Demographics
NPI:1700817004
Name:YONG, ANTONIO G (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:G
Last Name:YONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4960 SW 171ST TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4920
Mailing Address - Country:US
Mailing Address - Phone:954-322-2741
Mailing Address - Fax:954-322-2741
Practice Address - Street 1:445 E 25TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3810
Practice Address - Country:US
Practice Address - Phone:305-559-0568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-024642207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD-60091Medicare UPIN
FL92519Medicare ID - Type UnspecifiedMEDICARE