Provider Demographics
NPI:1275410698
Name:RODRIGUEZ BRUNET, YANELYS EVELIN
Entity type:Individual
Prefix:
First Name:YANELYS
Middle Name:EVELIN
Last Name:RODRIGUEZ BRUNET
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 1:16523 NW 83RD PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3470
Mailing Address - Country:US
Mailing Address - Phone:786-548-8819
Mailing Address - Fax:
Practice Address - Street 1:16523 NW 83RD PL
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-3470
Practice Address - Country:US
Practice Address - Phone:786-548-8819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-430161106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician