Provider Demographics
NPI:1427340199
Name:YANEZ, GIRALT (MD)
Entity type:Individual
Prefix:DR
First Name:GIRALT
Middle Name:
Last Name:YANEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8529 PINES BLVD
Mailing Address - Street 2:CHEN MEDICAL PEMBROKE PINES, INC
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6611
Mailing Address - Country:US
Mailing Address - Phone:954-704-3300
Mailing Address - Fax:954-800-2071
Practice Address - Street 1:8529 PINES BLVD
Practice Address - Street 2:CHEN MEDICAL PEMBROKE PINES, INC
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6611
Practice Address - Country:US
Practice Address - Phone:954-704-3300
Practice Address - Fax:954-800-2071
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME120104207R00000X
FL10117246ZS0410X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program