| Ygongoranp Llc | |
|
540 Nw 165th St Ste 310 Miami FL 33169-6342 | |
| (786) 562-7479 | |
| (305) 564-7610 |
| Full Name | Ygongoranp Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 540 Nw 165th St Ste 310, Miami, Florida |
| Authorized Official Name and Position | Yovany Gongora (OWNER) |
| Authorized Official Contact | 7866601844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ygongoranp Llc 540 Nw 165th St Ste 310 Miami FL 33169-6342 Ph: (786) 562-7479 | Ygongoranp Llc 540 Nw 165th St Ste 310 Miami FL 33169-6342 Ph: (786) 562-7479 |
| NPI Number | 1275392805 |
|---|---|
| Provider Enumeration Date | 03/18/2024 |
| Last Update Date | 08/13/2025 |
| Medicare PECOS PAC ID | 1153761572 |
|---|---|
| Medicare Enrollment ID | O20240502002139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275392805 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Yovany Gongora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962140434 PECOS PAC ID: 7618318205 Enrollment ID: I20240514002367 |
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