Healthcare Provider Details

I. General information

NPI: 1689267833
Provider Name (Legal Business Name): YEIMI SOSA DE LA CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 SW 22ND ST
CAPE CORAL FL
33991-7706
US

IV. Provider business mailing address

515 SW 22ND ST
CAPE CORAL FL
33991-7706
US

V. Phone/Fax

Practice location:
  • Phone: 941-999-4917
  • Fax:
Mailing address:
  • Phone: 786-541-4205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: