Provider Demographics
NPI:1235314402
Name:YOLANDA BURGOS ZARATE MD PA
Entity type:Organization
Organization Name:YOLANDA BURGOS ZARATE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:BURGOS
Authorized Official - Last Name:ZARATE
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:305-503-4260
Mailing Address - Street 1:4308 ALTON RD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4556
Mailing Address - Country:US
Mailing Address - Phone:305-503-4206
Mailing Address - Fax:305-534-1421
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:SUITE 420
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4556
Practice Address - Country:US
Practice Address - Phone:305-503-4260
Practice Address - Fax:305-534-1421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00661592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF84297Medicare UPIN