Provider Demographics
NPI:1356681100
Name:CUBA, YARELIS (OTA 11514)
Entity type:Individual
Prefix:
First Name:YARELIS
Middle Name:
Last Name:CUBA
Suffix:
Gender:F
Credentials:OTA 11514
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 W 79TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-3535
Mailing Address - Country:US
Mailing Address - Phone:305-479-4673
Mailing Address - Fax:
Practice Address - Street 1:843 W 79TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-3535
Practice Address - Country:US
Practice Address - Phone:305-479-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OTA11514224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant