Provider Demographics
NPI:1083494066
Name:MANRESA MACHADO, YUSINEY (RBT)
Entity Type:Individual
Prefix:
First Name:YUSINEY
Middle Name:
Last Name:MANRESA MACHADO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10360 SW 212TH ST APT 205
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3088
Mailing Address - Country:US
Mailing Address - Phone:786-200-7783
Mailing Address - Fax:
Practice Address - Street 1:10360 SW 212TH ST APT 205
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-3088
Practice Address - Country:US
Practice Address - Phone:786-200-7783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-301065106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty