Provider Demographics
NPI:1083489710
Name:SERRANO, YENEISY
Entity Type:Individual
Prefix:
First Name:YENEISY
Middle Name:
Last Name:SERRANO
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 1:1225 W 35TH ST APT 30A
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4872
Mailing Address - Country:US
Mailing Address - Phone:423-708-0091
Mailing Address - Fax:
Practice Address - Street 1:1225 W 35TH ST APT 30A
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4872
Practice Address - Country:US
Practice Address - Phone:423-708-0091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician