Provider Demographics
NPI:1265046833
Name:CABALLERO, YURLENKA
Entity type:Individual
Prefix:
First Name:YURLENKA
Middle Name:
Last Name:CABALLERO
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 1:70 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-2634
Mailing Address - Country:US
Mailing Address - Phone:786-597-3291
Mailing Address - Fax:
Practice Address - Street 1:2100 W 76TH ST STE 202
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5503
Practice Address - Country:US
Practice Address - Phone:305-606-4836
Practice Address - Fax:786-558-5005
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26344225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty