Provider Demographics
NPI:1063042745
Name:HERNANDEZ VALDIVIA, YULENIA
Entity Type:Individual
Prefix:
First Name:YULENIA
Middle Name:
Last Name:HERNANDEZ VALDIVIA
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 1:5085 NW 7TH ST APT 514
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3453
Mailing Address - Country:US
Mailing Address - Phone:786-378-0741
Mailing Address - Fax:
Practice Address - Street 1:5085 NW 7TH ST APT 514
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3453
Practice Address - Country:US
Practice Address - Phone:786-378-0741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-106686106S00000X
FL9483399163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty