Provider Demographics
NPI:1811574437
Name:MARTINEZ LIMA, YENNEIS SR (RBT)
Entity Type:Individual
Prefix:MS
First Name:YENNEIS
Middle Name:
Last Name:MARTINEZ LIMA
Suffix:SR
Gender:F
Credentials:RBT
Other - Prefix:MS
Other - First Name:YENNEIS
Other - Middle Name:
Other - Last Name:MARTINEZ LIMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:10369 SW 88TH ST APT F7
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1670
Mailing Address - Country:US
Mailing Address - Phone:786-630-0341
Mailing Address - Fax:
Practice Address - Street 1:10369 SW 88TH ST APT F7
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1670
Practice Address - Country:US
Practice Address - Phone:305-908-2999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-28
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL107123700106S00000X
FL106S00000X
106S00000X
FLM635960867610106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician