Provider Demographics
NPI:1881028827
Name:Y&M DOCTOR MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:Y&M DOCTOR MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOSVANY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-261-1718
Mailing Address - Street 1:5755 W FLAGLER ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3441
Mailing Address - Country:US
Mailing Address - Phone:305-261-1718
Mailing Address - Fax:305-261-1747
Practice Address - Street 1:5755 W FLAGLER ST
Practice Address - Street 2:SUITE 214
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3441
Practice Address - Country:US
Practice Address - Phone:305-261-1718
Practice Address - Fax:305-261-1747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO065324305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service