Provider Demographics
NPI:1295412104
Name:CANELL QUINONES, YASMANI
Entity type:Individual
Prefix:
First Name:YASMANI
Middle Name:
Last Name:CANELL QUINONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6337 TREETOP CIR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2715
Mailing Address - Country:US
Mailing Address - Phone:813-484-2314
Mailing Address - Fax:813-433-5163
Practice Address - Street 1:7406 W ELM ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3305
Practice Address - Country:US
Practice Address - Phone:504-290-9697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist