Provider Demographics
NPI:1215141395
Name:KOCH, YVONNE KATHERINE PIEDRAHITA (MD)
Entity type:Individual
Prefix:DR
First Name:YVONNE KATHERINE
Middle Name:PIEDRAHITA
Last Name:KOCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YVONNE
Other - Middle Name:KATHERINE
Other - Last Name:PIEDRAHITA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4300 ALTON RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2800
Mailing Address - Country:US
Mailing Address - Phone:305-674-2655
Mailing Address - Fax:
Practice Address - Street 1:4300 ALTON RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2948
Practice Address - Country:US
Practice Address - Phone:305-674-2655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTEMPORARY208800000X
FLME99583208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology