MEDICARE: YUNIER GARCIA BLANCHET

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	21-156534	FL

General Provider Information

NPI Number	:	1114502002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUNIER GARCIA BLANCHET

Provider Business Mailing Address
First Line	:	3935 SERUBI AVE
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4023
Country	:	US
Telephone Number	:	305-303-9353
Fax Number	:

Provider Business Practice Location Address
First Line	:	3935 SERUBI AVE
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4023
Country	:	US
Telephone Number	:	305-303-9353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2021
Last Update Date	:	03/12/2021

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