Provider Demographics
NPI:1891977971
Name:MILANES, YISSEL A
Entity Type:Individual
Prefix:
First Name:YISSEL
Middle Name:A
Last Name:MILANES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 NW 7TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5535
Mailing Address - Country:US
Mailing Address - Phone:305-644-9970
Mailing Address - Fax:305-644-7394
Practice Address - Street 1:4150 NW 7TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5535
Practice Address - Country:US
Practice Address - Phone:305-644-9970
Practice Address - Fax:305-644-7394
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor