Provider Demographics
NPI:1174513683
Name:GUERRA-NEGRETE, YAMILE (MD)
Entity type:Individual
Prefix:MS
First Name:YAMILE
Middle Name:
Last Name:GUERRA-NEGRETE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10621 N KENDALL DR
Mailing Address - Street 2:STE 213
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1530
Mailing Address - Country:US
Mailing Address - Phone:305-412-0071
Mailing Address - Fax:305-412-0361
Practice Address - Street 1:10621 N KENDALL DR
Practice Address - Street 2:STE 213
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1530
Practice Address - Country:US
Practice Address - Phone:305-412-0071
Practice Address - Fax:305-412-0361
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 67853208000000X
NY196994 1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G25145Medicare UPIN
FL28177Medicare ID - Type Unspecified