Provider Demographics
NPI:1700663671
Name:NUNEZ VILLEGAS, YENISEL B
Entity Type:Individual
Prefix:
First Name:YENISEL
Middle Name:B
Last Name:NUNEZ VILLEGAS
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 1:652 TAMIAMI BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2652
Mailing Address - Country:US
Mailing Address - Phone:786-920-1688
Mailing Address - Fax:
Practice Address - Street 1:652 TAMIAMI BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2652
Practice Address - Country:US
Practice Address - Phone:786-920-1688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst