Provider Demographics
NPI:1841948015
Name:MULET LOPEZ, YOLAMIS
Entity type:Individual
Prefix:
First Name:YOLAMIS
Middle Name:
Last Name:MULET LOPEZ
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 1:11590 SW 248TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-3431
Mailing Address - Country:US
Mailing Address - Phone:786-828-4048
Mailing Address - Fax:
Practice Address - Street 1:7791 NW 46TH ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-5477
Practice Address - Country:US
Practice Address - Phone:786-236-3949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician