Provider Demographics
NPI:1093592321
Name:FERNANDEZ, YELINA (PSYD)
Entity Type:Individual
Prefix:
First Name:YELINA
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SE 4TH AVE STE 816B
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-6498
Mailing Address - Country:US
Mailing Address - Phone:305-587-7737
Mailing Address - Fax:305-517-5377
Practice Address - Street 1:800 SE 4TH AVE STE 816B
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-6498
Practice Address - Country:US
Practice Address - Phone:305-587-7737
Practice Address - Fax:305-517-5377
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY12001103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical