Provider Demographics
NPI:1841031366
Name:SUAREZ, YUMIRNA CAROLINA
Entity type:Individual
Prefix:MISS
First Name:YUMIRNA
Middle Name:CAROLINA
Last Name:SUAREZ
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 1:4482 BLUFF OAK LOOP
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-2346
Mailing Address - Country:US
Mailing Address - Phone:407-860-1455
Mailing Address - Fax:
Practice Address - Street 1:4482 BLUFF OAK LOOP
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-2346
Practice Address - Country:US
Practice Address - Phone:407-860-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-352061106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty