Basic Information
| Provider Information | |||||||||
| NPI: | 1326403684 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YANES | ||||||||
| FirstName: | MAILENE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13715 SW 32ND ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331756650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052812677 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7135 SW 117TH AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331832802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8446654827 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2015 | ||||||||
| LastUpdateDate: | 10/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | ME139645 | FL | Y | Allopathic & Osteopathic Physicians | General Practice | 207Q00000X | ACN914 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 208D00000X | 19461 | PR | N | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.