Provider Demographics
NPI:1619688454
Name:ECHEVARRIA DIAZ, YUSLEYDIS
Entity Type:Individual
Prefix:
First Name:YUSLEYDIS
Middle Name:
Last Name:ECHEVARRIA DIAZ
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 1:885 NE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4771
Mailing Address - Country:US
Mailing Address - Phone:305-414-9981
Mailing Address - Fax:
Practice Address - Street 1:885 NE 3RD AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4771
Practice Address - Country:US
Practice Address - Phone:305-414-9981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician