Provider Demographics
NPI:1750170585
Name:DORTA, YANELA
Entity type:Individual
Prefix:
First Name:YANELA
Middle Name:
Last Name:DORTA
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 1:47 NW 46TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5359
Mailing Address - Country:US
Mailing Address - Phone:786-412-1990
Mailing Address - Fax:
Practice Address - Street 1:47 NW 46TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5359
Practice Address - Country:US
Practice Address - Phone:786-412-1990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician