Provider Demographics
NPI:1962009597
Name:SARDINAS DE LA TORRE, YANELYS
Entity Type:Individual
Prefix:
First Name:YANELYS
Middle Name:
Last Name:SARDINAS DE LA TORRE
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 1:9631 FONTAINEBLEAU BLVD APT 409
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-6861
Mailing Address - Country:US
Mailing Address - Phone:786-614-6588
Mailing Address - Fax:
Practice Address - Street 1:9631 FONTAINEBLEAU BLVD APT 409
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-6861
Practice Address - Country:US
Practice Address - Phone:786-614-6588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician