Provider Demographics
NPI:1578225660
Name:BENTANCOURT, YAZMEEN SKYLAR
Entity Type:Individual
Prefix:
First Name:YAZMEEN
Middle Name:SKYLAR
Last Name:BENTANCOURT
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 1:5406 HITCHING POST LN
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-3114
Mailing Address - Country:US
Mailing Address - Phone:361-510-9921
Mailing Address - Fax:
Practice Address - Street 1:5406 HITCHING POST LN
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-3114
Practice Address - Country:US
Practice Address - Phone:361-510-9921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program