Provider Demographics
NPI:1912573973
Name:REGUEIRO FERNANDEZ, YELEINIS
Entity Type:Individual
Prefix:
First Name:YELEINIS
Middle Name:
Last Name:REGUEIRO FERNANDEZ
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 1:101 NW 47TH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5247
Mailing Address - Country:US
Mailing Address - Phone:786-498-0996
Mailing Address - Fax:
Practice Address - Street 1:101 NW 47TH AVE APT 1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5247
Practice Address - Country:US
Practice Address - Phone:786-498-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician