Provider Demographics
NPI:1972037927
Name:HECTOR, YANISLEIDY
Entity Type:Individual
Prefix:
First Name:YANISLEIDY
Middle Name:
Last Name:HECTOR
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 1:6850 W 16TH DR APT 219
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4459
Mailing Address - Country:US
Mailing Address - Phone:305-401-6607
Mailing Address - Fax:
Practice Address - Street 1:6850 W 16TH DR APT 219
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4459
Practice Address - Country:US
Practice Address - Phone:305-401-6607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician