Provider Demographics
NPI:1659779692
Name:SANCHEZ BERNAL, YORDALYS
Entity Type:Individual
Prefix:
First Name:YORDALYS
Middle Name:
Last Name:SANCHEZ BERNAL
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 1:5851 W 20TH AVE APT 415
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7560
Mailing Address - Country:US
Mailing Address - Phone:786-312-5378
Mailing Address - Fax:
Practice Address - Street 1:12741 SW 17TH CT
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2500
Practice Address - Country:US
Practice Address - Phone:786-285-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA14132225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist