Provider Demographics
NPI:1205696309
Name:POLO, YANAIG
Entity type:Individual
Prefix:
First Name:YANAIG
Middle Name:
Last Name:POLO
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 1:1475 SW 8TH ST APT 411
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-3891
Mailing Address - Country:US
Mailing Address - Phone:305-548-1074
Mailing Address - Fax:
Practice Address - Street 1:1475 SW 8TH ST APT 411
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-3891
Practice Address - Country:US
Practice Address - Phone:305-548-1074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program