Provider Demographics
NPI:1740802644
Name:BELLIDO DE LUNA, YANIA
Entity Type:Individual
Prefix:
First Name:YANIA
Middle Name:
Last Name:BELLIDO DE LUNA
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 1:8241 NW 165TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3471
Mailing Address - Country:US
Mailing Address - Phone:305-590-1682
Mailing Address - Fax:
Practice Address - Street 1:8241 NW 165TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-3471
Practice Address - Country:US
Practice Address - Phone:305-590-1682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst