Provider Demographics
NPI:1295378131
Name:ROJAS ABREU, YOANDRA
Entity Type:Individual
Prefix:MS
First Name:YOANDRA
Middle Name:
Last Name:ROJAS ABREU
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 1:426 E 62ND ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1143
Mailing Address - Country:US
Mailing Address - Phone:786-612-4358
Mailing Address - Fax:305-863-7347
Practice Address - Street 1:426 E 62ND ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1143
Practice Address - Country:US
Practice Address - Phone:786-612-4358
Practice Address - Fax:305-863-7347
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-102488103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-19-102488Medicaid