Provider Demographics
NPI:1306852330
Name:VARGAS FERNANDEZ, YUNIERT M (LMFT)
Entity Type:Individual
Prefix:
First Name:YUNIERT
Middle Name:M
Last Name:VARGAS FERNANDEZ
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8151 SW 160TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3071
Mailing Address - Country:US
Mailing Address - Phone:305-385-3078
Mailing Address - Fax:
Practice Address - Street 1:2721 SW 137TH AVE STE 113
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6355
Practice Address - Country:US
Practice Address - Phone:786-558-7248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 101Y00000X, 106H00000X
FLMT 2491106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL767623900Medicaid