Provider Demographics
NPI:1245803733
Name:IRIBARNEGARAY, YOEL
Entity Type:Individual
Prefix:
First Name:YOEL
Middle Name:
Last Name:IRIBARNEGARAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 SE 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1003
Mailing Address - Country:US
Mailing Address - Phone:786-327-3743
Mailing Address - Fax:
Practice Address - Street 1:202 SE 1ST AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-1003
Practice Address - Country:US
Practice Address - Phone:786-327-3743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst