Provider Demographics
NPI:1790539500
Name:SANABRIA GUERRA, YENISET
Entity Type:Individual
Prefix:
First Name:YENISET
Middle Name:
Last Name:SANABRIA GUERRA
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 1:3854 HEATHER DR E
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3016
Mailing Address - Country:US
Mailing Address - Phone:561-396-8143
Mailing Address - Fax:
Practice Address - Street 1:3854 HEATHER DR E
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3016
Practice Address - Country:US
Practice Address - Phone:561-396-8143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-338509106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty