Provider Demographics
NPI:1972267367
Name:JUIZ, YANELA
Entity Type:Individual
Prefix:
First Name:YANELA
Middle Name:
Last Name:JUIZ
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 1:4955 NW 199TH ST LOT 424
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-1777
Mailing Address - Country:US
Mailing Address - Phone:786-817-9470
Mailing Address - Fax:
Practice Address - Street 1:4955 NW 199TH ST LOT 424
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-1777
Practice Address - Country:US
Practice Address - Phone:786-817-9470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician