Provider Demographics
NPI:1073955498
Name:LASSITER, YORELL MASIO SR (MBA)
Entity Type:Individual
Prefix:MR
First Name:YORELL
Middle Name:MASIO
Last Name:LASSITER
Suffix:SR
Gender:M
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 NW 6TH CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1463
Mailing Address - Country:US
Mailing Address - Phone:954-240-0789
Mailing Address - Fax:
Practice Address - Street 1:4651 NW 6TH CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1463
Practice Address - Country:US
Practice Address - Phone:954-240-0789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker