Provider Demographics
NPI:1568961282
Name:HERNANDEZ, YESI (RBT)
Entity Type:Individual
Prefix:
First Name:YESI
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:YESI
Other - Middle Name:
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:YESI HERNANDEZ, RBT
Mailing Address - Street 1:2330 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1519
Mailing Address - Country:US
Mailing Address - Phone:786-719-2987
Mailing Address - Fax:
Practice Address - Street 1:1401 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2261
Practice Address - Country:US
Practice Address - Phone:305-400-8998
Practice Address - Fax:786-360-1296
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician