Provider Demographics
NPI:1528025079
Name:YEFET, NELLY LEAH (AP)
Entity Type:Individual
Prefix:
First Name:NELLY
Middle Name:LEAH
Last Name:YEFET
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21402 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1144
Mailing Address - Country:US
Mailing Address - Phone:305-933-2360
Mailing Address - Fax:305-933-5727
Practice Address - Street 1:21402 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1144
Practice Address - Country:US
Practice Address - Phone:305-933-2360
Practice Address - Fax:305-933-5727
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 963171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist