1851498570 NPI number — JULIAN A YONG MD

Table of content: JULIAN A YONG MD (NPI 1851498570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851498570 NPI number — JULIAN A YONG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YONG
Provider First Name:
JULIAN
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851498570
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 E 25TH ST
Provider Second Line Business Mailing Address:
SUITE 312
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33013-3825
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-696-0133
Provider Business Mailing Address Fax Number:
305-691-0659

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 E 25TH ST
Provider Second Line Business Practice Location Address:
SUITE 312
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33013-3825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-696-0133
Provider Business Practice Location Address Fax Number:
305-691-0659
Provider Enumeration Date:
09/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  ME20442 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2168178 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 217369 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 52753 . This is a "JMH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 059142400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000M8 . This is a "PREFERRED CARE PARTNERS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0089HILH . This is a "NEIGHBORHOODHEALTHPARTNER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 92512 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 17541 . This is a "HUMANA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 9624954 . This is a "GHI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P00319706 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 17541 . This is a "WELL CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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