Provider Demographics
NPI:1700515384
Name:HERNANDEZ LOPEZ, YUSDAY DE LA CARIDAD
Entity Type:Individual
Prefix:
First Name:YUSDAY
Middle Name:DE LA CARIDAD
Last Name:HERNANDEZ LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8013 W 6TH AVE APT F
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4107
Mailing Address - Country:US
Mailing Address - Phone:786-547-2458
Mailing Address - Fax:
Practice Address - Street 1:8013 W 6TH AVE APT F
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4107
Practice Address - Country:US
Practice Address - Phone:786-547-2458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-140128106S00000X
FLBCABA-0-23-14958106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician