Provider Demographics
NPI:1275261265
Name:GHOUBAR, YAMILY
Entity Type:Individual
Prefix:
First Name:YAMILY
Middle Name:
Last Name:GHOUBAR
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 1:1773 RED CANYON DR
Mailing Address - Street 2:
Mailing Address - City:KINDRED
Mailing Address - State:FL
Mailing Address - Zip Code:34744-6264
Mailing Address - Country:US
Mailing Address - Phone:561-215-5637
Mailing Address - Fax:
Practice Address - Street 1:1773 RED CANYON DR
Practice Address - Street 2:
Practice Address - City:KINDRED
Practice Address - State:FL
Practice Address - Zip Code:34744-6264
Practice Address - Country:US
Practice Address - Phone:561-215-5637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management