Provider Demographics
NPI:1235587262
Name:MESA PADRON, YUNAISY L
Entity Type:Individual
Prefix:
First Name:YUNAISY
Middle Name:L
Last Name:MESA PADRON
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 1:3625 NE 19TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-7311
Mailing Address - Country:US
Mailing Address - Phone:305-878-5746
Mailing Address - Fax:
Practice Address - Street 1:3625 NE 19TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-7311
Practice Address - Country:US
Practice Address - Phone:305-878-5746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-15-04814106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician