Provider Demographics
NPI:1467134452
Name:PARDO GARCIA, YANET (RBT)
Entity Type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:PARDO GARCIA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19800 SW 110TH CT # B209
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-8430
Mailing Address - Country:US
Mailing Address - Phone:305-876-5638
Mailing Address - Fax:
Practice Address - Street 1:19800 SW 110TH CT # B209
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-8430
Practice Address - Country:US
Practice Address - Phone:305-876-5638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT23280315106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty