Provider Demographics
NPI:1922824754
Name:RAMOS POLO, YITSSY (APRN)
Entity type:Individual
Prefix:
First Name:YITSSY
Middle Name:
Last Name:RAMOS POLO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8306 NW 143RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5738
Mailing Address - Country:US
Mailing Address - Phone:305-549-4678
Mailing Address - Fax:
Practice Address - Street 1:6600 COW PEN RD STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-7618
Practice Address - Country:US
Practice Address - Phone:786-453-9803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine