Provider Demographics
NPI:1275159972
Name:MORALES PITA, YAIMA DE LA CARIDAD
Entity Type:Individual
Prefix:
First Name:YAIMA
Middle Name:DE LA CARIDAD
Last Name:MORALES PITA
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 1:633 E 45TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1921
Mailing Address - Country:US
Mailing Address - Phone:786-752-2894
Mailing Address - Fax:
Practice Address - Street 1:633 E 45TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1921
Practice Address - Country:US
Practice Address - Phone:786-752-2894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-123574106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician