Provider Demographics
NPI:1669271011
Name:ALONSO BRUNET, YANNARY
Entity type:Individual
Prefix:
First Name:YANNARY
Middle Name:
Last Name:ALONSO BRUNET
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 SW 111TH AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6970
Mailing Address - Country:US
Mailing Address - Phone:305-417-3407
Mailing Address - Fax:
Practice Address - Street 1:520 SW 111TH AVE APT 204
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-6970
Practice Address - Country:US
Practice Address - Phone:305-417-3407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-414382106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician