Provider Demographics
NPI:1639813249
Name:FERNANDEZ ARAPE, YORMAYLIN A
Entity Type:Individual
Prefix:
First Name:YORMAYLIN
Middle Name:A
Last Name:FERNANDEZ ARAPE
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 1:3300 PEMBROKE RD LOT 328
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8379
Mailing Address - Country:US
Mailing Address - Phone:786-870-3620
Mailing Address - Fax:
Practice Address - Street 1:3300 PEMBROKE RD LOT 328
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8379
Practice Address - Country:US
Practice Address - Phone:786-870-3620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-197530106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113913100Medicaid