Provider Demographics
NPI:1114423910
Name:ANDREU SIBERIO, YAHILY
Entity Type:Individual
Prefix:
First Name:YAHILY
Middle Name:
Last Name:ANDREU SIBERIO
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 1:12255 SW 39TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3013
Mailing Address - Country:US
Mailing Address - Phone:786-521-4183
Mailing Address - Fax:
Practice Address - Street 1:4720 SW 97TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5876
Practice Address - Country:US
Practice Address - Phone:786-525-6967
Practice Address - Fax:786-607-9398
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19160225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty