Healthcare Provider Details

I. General information

NPI: 1508681438
Provider Name (Legal Business Name): JUAN CARLOS YEPES MUSIC THERAPY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2024
Last Update Date: 11/16/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 NW 95TH ST STE 337
HIALEAH GARDENS FL
33016-2361
US

IV. Provider business mailing address

9297 W 32ND LN
HIALEAH FL
33018-2062
US

V. Phone/Fax

Practice location:
  • Phone: 954-793-0775
  • Fax: 786-641-5968
Mailing address:
  • Phone: 954-478-2687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: