Provider Demographics
NPI:1437672375
Name:ORIVE ROSELLO, YAREMYS
Entity Type:Individual
Prefix:
First Name:YAREMYS
Middle Name:
Last Name:ORIVE ROSELLO
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 1:12283 SW 144TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7479
Mailing Address - Country:US
Mailing Address - Phone:786-212-6575
Mailing Address - Fax:
Practice Address - Street 1:12283 SW 144TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7479
Practice Address - Country:US
Practice Address - Phone:786-212-6575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-23
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-117083106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty