Provider Demographics
NPI:1003418344
Name:PRADO SANTOS, YANET
Entity Type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:PRADO SANTOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10421 NW 35TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-1040
Mailing Address - Country:US
Mailing Address - Phone:786-294-5721
Mailing Address - Fax:
Practice Address - Street 1:800 NW 172ND TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-5305
Practice Address - Country:US
Practice Address - Phone:786-294-5721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health Aide