Provider Demographics
NPI:1639792294
Name:MORALES HERNANDEZ, YOEL
Entity Type:Individual
Prefix:
First Name:YOEL
Middle Name:
Last Name:MORALES HERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11020 SW 196TH ST APT B213
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-8304
Mailing Address - Country:US
Mailing Address - Phone:786-315-8639
Mailing Address - Fax:
Practice Address - Street 1:11120 SW 196TH ST APT B213
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-8312
Practice Address - Country:US
Practice Address - Phone:786-315-8639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-20-11402106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst