Provider Demographics
NPI:1891827465
Name:ODIA, YAZMIN (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:YAZMIN
Middle Name:
Last Name:ODIA
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:DR
Other - First Name:YAZMIN
Other - Middle Name:
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MS
Mailing Address - Street 1:PO BOX 743144
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3144
Mailing Address - Country:US
Mailing Address - Phone:786-596-2000
Mailing Address - Fax:305-279-7778
Practice Address - Street 1:8900 N KENDALL DR
Practice Address - Street 2:MIAMI CANCER INSTITUTE
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2118
Practice Address - Country:US
Practice Address - Phone:786-596-2000
Practice Address - Fax:305-279-7778
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1281802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019097800Medicaid