| Doctor Name: | MR. YUSDENY FAJARDO |
| NPI Number: | 1588690200 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | V.P. |
| License Number: | ME37781 |
| Business Practice Address: | 3900 Nw 79th Ave Suite 322 Doral, FL - 331666556 |
| Business Phone Number: | 3054719500 |
| Business Fax Number: | 3054719870 |
| Mailing Address: | 3900 Nw 79th Ave, Suite 322 DORAL |
| State: | FL |
| Postal Code: | 331666556 |
| Phone Number: | 3054719500 |
| Fax Number: | 3054719870 |
| NPI Enumeration Date: | 06/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME37781 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |