Provider Demographics
NPI:1750262770
Name:YANES, MORAIMA
Entity type:Individual
Prefix:
First Name:MORAIMA
Middle Name:
Last Name:YANES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12249 SW 14TH LN APT 1109
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2869
Mailing Address - Country:US
Mailing Address - Phone:786-487-0926
Mailing Address - Fax:
Practice Address - Street 1:12249 SW 14TH LN APT 1109
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-2869
Practice Address - Country:US
Practice Address - Phone:786-487-0926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11041778207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine