Provider Demographics
NPI:1790422483
Name:DIAZ PALMERO, YURANIS
Entity Type:Individual
Prefix:
First Name:YURANIS
Middle Name:
Last Name:DIAZ PALMERO
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 1:2010 NW 184TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-2752
Mailing Address - Country:US
Mailing Address - Phone:786-907-7259
Mailing Address - Fax:
Practice Address - Street 1:3785 NW 82ND AVE STE 307
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6631
Practice Address - Country:US
Practice Address - Phone:305-266-2949
Practice Address - Fax:786-451-1200
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPMH1903101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health