Provider Demographics
NPI:1649703935
Name:FUENTES, YOHANDY (DPM)
Entity type:Individual
Prefix:
First Name:YOHANDY
Middle Name:
Last Name:FUENTES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11840 SW 18TH TER APT 89
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-8738
Mailing Address - Country:US
Mailing Address - Phone:305-335-4663
Mailing Address - Fax:
Practice Address - Street 1:3659 S MIAMI AVE
Practice Address - Street 2:SUITE 3008
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4227
Practice Address - Country:US
Practice Address - Phone:305-859-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2020-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL528213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery