Provider Demographics
NPI:1013267137
Name:SMITH, RAQUEL YUANCLYN (BSW)
Entity Type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:YUANCLYN
Last Name:SMITH
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 S MIAMI AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1628
Mailing Address - Country:US
Mailing Address - Phone:305-779-9600
Mailing Address - Fax:305-779-9601
Practice Address - Street 1:155 S MIAMI AVE STE 700
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1628
Practice Address - Country:US
Practice Address - Phone:305-779-9600
Practice Address - Fax:305-779-9601
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical