Healthcare Provider Details

I. General information

NPI: 1578382842
Provider Name (Legal Business Name): YANET FORTE TEJERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2024
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4793 N CONGRESS AVE STE 203
BOYNTON BEACH FL
33426-7937
US

IV. Provider business mailing address

520 JENNINGS AVE
GREENACRES FL
33463-2028
US

V. Phone/Fax

Practice location:
  • Phone: 561-429-3863
  • Fax: 561-448-6063
Mailing address:
  • Phone: 305-890-3223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-382244
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: