MEDICARE: YISEL CORREA MONTERO

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	106S00000X	Behavior Technician
2	171M00000X	Case Manager/Care Coordinator
3	104100000X	Social Worker

General Provider Information

NPI Number	:	1407384399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YISEL CORREA MONTERO

Provider Business Mailing Address
First Line	:	2500 E HALLANDALE BEACH BLVD STE 802
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4841
Country	:	US
Telephone Number	:	863-220-8627
Fax Number	:	954-272-7854

Provider Business Practice Location Address
First Line	:	2500 E HALLANDALE BEACH BLVD STE 802
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4841
Country	:	US
Telephone Number	:	863-220-8627
Fax Number	:	954-272-7854

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

Provider Enumeration Date	:	05/23/2017
Last Update Date	:	03/25/2026

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Directions to “ YISEL CORREA MONTERO ” Practice Location

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