Provider Demographics
NPI:1730227489
Name:M & Y PROFESSIONAL SERVICE, CORP
Entity type:Organization
Organization Name:M & Y PROFESSIONAL SERVICE, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:YISSEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-469-3978
Mailing Address - Street 1:4150 NW 7TH ST
Mailing Address - Street 2:STE 201
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:
Practice Address - Street 1:4150 NW 7TH ST
Practice Address - Street 2:STE 201
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1313258332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5945850001Medicare NSC