Provider Demographics
NPI:1770079139
Name:BORGES, YOJANDRY
Entity type:Individual
Prefix:
First Name:YOJANDRY
Middle Name:
Last Name:BORGES
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 1:3510 NW 89TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-2866
Mailing Address - Country:US
Mailing Address - Phone:786-970-9935
Mailing Address - Fax:
Practice Address - Street 1:3510 NW 89TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-2866
Practice Address - Country:US
Practice Address - Phone:786-970-9935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020766400Medicaid