Provider Demographics
NPI:1659988145
Name:ARENAS BRAVO, YEBELICE AURORA
Entity Type:Individual
Prefix:
First Name:YEBELICE
Middle Name:AURORA
Last Name:ARENAS BRAVO
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 1:8860 FONTAINEBLEAU BLVD APT 105
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4439
Mailing Address - Country:US
Mailing Address - Phone:786-210-9810
Mailing Address - Fax:
Practice Address - Street 1:6303 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4825
Practice Address - Country:US
Practice Address - Phone:786-620-6948
Practice Address - Fax:954-206-0906
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator