Provider Demographics
NPI:1265988125
Name:LAU, YUDEYLIS (BS)
Entity type:Individual
Prefix:
First Name:YUDEYLIS
Middle Name:
Last Name:LAU
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11390 SW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1122
Mailing Address - Country:US
Mailing Address - Phone:305-972-6739
Mailing Address - Fax:
Practice Address - Street 1:5901 NW 183RD ST STE 310
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-6008
Practice Address - Country:US
Practice Address - Phone:786-418-9790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker