Healthcare Provider Details

I. General information

NPI: 1003737198
Provider Name (Legal Business Name): YVENIDE BELIZAIRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 NW 3RD AVE FL 33063
DEERFIELD BEACH FL
33064-2520
US

IV. Provider business mailing address

2610 E MARINA BAY DR # 5-608
FORT LAUDERDALE FL
33312-2339
US

V. Phone/Fax

Practice location:
  • Phone: 954-760-9800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMT4481
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: