Provider Demographics
NPI:1720742307
Name:GARCIA QUESADA, YOLANDA N/A (CBHCMP)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:N/A
Last Name:GARCIA QUESADA
Suffix:
Gender:F
Credentials:CBHCMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 SW 66TH AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4839
Mailing Address - Country:US
Mailing Address - Phone:786-334-0966
Mailing Address - Fax:
Practice Address - Street 1:11685 CANAL DR APT 204
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3228
Practice Address - Country:US
Practice Address - Phone:786-334-0966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIND-895795171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator