Healthcare Provider Details

I. General information

NPI: 1790428126
Provider Name (Legal Business Name): YONIEL PEREZ ARENCIBIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 SW 26TH PL
CAPE CORAL FL
33991-1132
US

IV. Provider business mailing address

322 SW 26TH PL
CAPE CORAL FL
33991-1132
US

V. Phone/Fax

Practice location:
  • Phone: 786-327-1048
  • Fax:
Mailing address:
  • Phone: 786-327-1048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: