Provider Demographics
NPI:1750970877
Name:CARPIO PINEDA, YANET
Entity type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:CARPIO PINEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YANET
Other - Middle Name:
Other - Last Name:CARPIO PINEDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3830 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4416
Mailing Address - Country:US
Mailing Address - Phone:786-901-1526
Mailing Address - Fax:
Practice Address - Street 1:3830 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4416
Practice Address - Country:US
Practice Address - Phone:786-901-1526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108376500Medicaid