Provider Demographics
NPI:1659877314
Name:MONTERO, YUSLEIDY
Entity Type:Individual
Prefix:
First Name:YUSLEIDY
Middle Name:
Last Name:MONTERO
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 1:1754 MERIDIAN AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-1868
Mailing Address - Country:US
Mailing Address - Phone:786-355-4922
Mailing Address - Fax:
Practice Address - Street 1:500 NW 36TH ST APT 1201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-3155
Practice Address - Country:US
Practice Address - Phone:786-355-4922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020849800Medicaid