Provider Demographics
NPI:1225678584
Name:GUILARTE HERNANDEZ, YAIMA
Entity Type:Individual
Prefix:
First Name:YAIMA
Middle Name:
Last Name:GUILARTE HERNANDEZ
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 1:7221 SW 5TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2743
Mailing Address - Country:US
Mailing Address - Phone:786-343-8890
Mailing Address - Fax:
Practice Address - Street 1:8100 NW 155TH ST STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5865
Practice Address - Country:US
Practice Address - Phone:786-718-3491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20-109627106S00000X
FL1-23-67613103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty