Provider Demographics
NPI:1275319378
Name:SUAREZ SUAREZ, YENIMA (RBT-23-289378)
Entity Type:Individual
Prefix:
First Name:YENIMA
Middle Name:
Last Name:SUAREZ SUAREZ
Suffix:
Gender:F
Credentials:RBT-23-289378
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 W 30TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5462
Mailing Address - Country:US
Mailing Address - Phone:786-798-1236
Mailing Address - Fax:
Practice Address - Street 1:73 W 30TH ST APT 1
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5462
Practice Address - Country:US
Practice Address - Phone:786-798-1236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-289378106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty