Healthcare Provider Details

I. General information

NPI: 1285187039
Provider Name (Legal Business Name): HANY URDANETA RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18400 SW 86TH CT
CUTLER BAY FL
33157-7221
US

IV. Provider business mailing address

18400 SW 86TH CT
CUTLER BAY FL
33157-7221
US

V. Phone/Fax

Practice location:
  • Phone: 305-546-8880
  • Fax:
Mailing address:
  • Phone: 305-546-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11718
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: