Provider Demographics
NPI:1407532096
Name:PRUNEDA, YAMILE I
Entity Type:Individual
Prefix:MISS
First Name:YAMILE
Middle Name:
Last Name:PRUNEDA
Suffix:I
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 1:3268 NW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1016
Mailing Address - Country:US
Mailing Address - Phone:305-721-8050
Mailing Address - Fax:
Practice Address - Street 1:3268 NW 19TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1016
Practice Address - Country:US
Practice Address - Phone:305-721-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician