Provider Demographics
NPI:1962499426
Name:YAVAGAL, SUJATA (MD)
Entity type:Individual
Prefix:DR
First Name:SUJATA
Middle Name:
Last Name:YAVAGAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUJATA
Other - Middle Name:
Other - Last Name:MULYE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8940 N KENDALL DR STE 701E
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2100
Mailing Address - Country:US
Mailing Address - Phone:786-534-8884
Mailing Address - Fax:786-534-8845
Practice Address - Street 1:8940 N KENDALL DR STE 701E
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2100
Practice Address - Country:US
Practice Address - Phone:786-534-8884
Practice Address - Fax:786-534-8845
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101073207V00000X, 2088F0040X
NY002329207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0002471-00Medicaid
NY02634935Medicaid
FLAM268YMedicare PIN
NY02634935Medicaid