MEDICARE: YUDEYLIS LAU BS

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	104100000X	Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265988125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUDEYLIS LAU BS

Provider Business Mailing Address
First Line	:	11390 SW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-1122
Country	:	US
Telephone Number	:	305-972-6739
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 NW 183RD ST STE 310
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-6008
Country	:	US
Telephone Number	:	786-418-9790
Fax Number	:

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

Provider Enumeration Date	:	08/31/2016
Last Update Date	:	10/25/2021

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Directions to “ YUDEYLIS LAU BS” Practice Location

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