Provider Demographics
NPI:1023516051
Name:CORCHO AREVALO, YENI (CBHCMS)
Entity type:Individual
Prefix:
First Name:YENI
Middle Name:
Last Name:CORCHO AREVALO
Suffix:
Gender:F
Credentials:CBHCMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7382 NW 35TH TER UNIT 106
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1241
Mailing Address - Country:US
Mailing Address - Phone:305-335-9627
Mailing Address - Fax:305-402-6101
Practice Address - Street 1:1370 W 83RD ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-3462
Practice Address - Country:US
Practice Address - Phone:786-725-7837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-24
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCM100372104100000X
104100000X, 106S00000X
FLRN9473880163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No163W00000XNursing Service ProvidersRegistered Nurse