Healthcare Provider Details

I. General information

NPI: 1881418697
Provider Name (Legal Business Name): YUNIA OQUENDO CARTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2024
Last Update Date: 11/09/2024
Certification Date: 11/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 NE 19TH AVE
CAPE CORAL FL
33909-2716
US

IV. Provider business mailing address

114 NE 19TH AVE
CAPE CORAL FL
33909-2716
US

V. Phone/Fax

Practice location:
  • Phone: 239-258-2954
  • Fax:
Mailing address:
  • Phone: 239-258-2954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number1199563
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: