Healthcare Provider Details

I. General information

NPI: 1114486792
Provider Name (Legal Business Name): YUNETSI LOPEZ CASTRO MARTINEZ RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 10/01/2023
Certification Date: 10/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7808 NW 200TH TER
HIALEAH FL
33015-6604
US

IV. Provider business mailing address

7808 NW 200TH TER
HIALEAH FL
33015-6604
US

V. Phone/Fax

Practice location:
  • Phone: 786-352-4908
  • Fax:
Mailing address:
  • Phone: 786-352-4908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-21-12105
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: