Provider Demographics
NPI:1548778384
Name:BAEZ, YANERIS
Entity Type:Individual
Prefix:MRS
First Name:YANERIS
Middle Name:
Last Name:BAEZ
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 1:9682 FONTAINEBLEAU BLVD APT 606
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4120
Mailing Address - Country:US
Mailing Address - Phone:305-824-0230
Mailing Address - Fax:305-907-5322
Practice Address - Street 1:7941 W 30TH LN
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-3831
Practice Address - Country:US
Practice Address - Phone:954-990-9800
Practice Address - Fax:954-990-9800
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-15
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty