Provider Demographics
NPI:1669172003
Name:NETO, YURI SILVA
Entity type:Individual
Prefix:
First Name:YURI
Middle Name:SILVA
Last Name:NETO
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 1:11720 SW BENNINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2716
Mailing Address - Country:US
Mailing Address - Phone:772-708-9019
Mailing Address - Fax:
Practice Address - Street 1:11720 SW BENNINGTON CIR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2716
Practice Address - Country:US
Practice Address - Phone:772-708-9019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15795225X00000X
FLOT22511225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist