Healthcare Provider Details

I. General information

NPI: 1598432189
Provider Name (Legal Business Name): MS. YANETH MARIA VENTURA MARIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2021
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10455 OLD CUTLER RD APT 314
CUTLER BAY FL
33190-2067
US

IV. Provider business mailing address

10455 OLD CUTLER RD APT 314
CUTLER BAY FL
33190-2067
US

V. Phone/Fax

Practice location:
  • Phone: 786-560-0738
  • Fax:
Mailing address:
  • Phone: 786-560-0738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number20-123595
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: