Provider Demographics
NPI:1760256564
Name:JIMENEZ CABRERA, YANELIS (RBT-23-308071)
Entity Type:Individual
Prefix:
First Name:YANELIS
Middle Name:
Last Name:JIMENEZ CABRERA
Suffix:
Gender:F
Credentials:RBT-23-308071
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 SE 2ND PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5509
Mailing Address - Country:US
Mailing Address - Phone:305-709-8449
Mailing Address - Fax:
Practice Address - Street 1:965 SE 2ND PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5509
Practice Address - Country:US
Practice Address - Phone:305-709-8449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-308071106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician