Healthcare Provider Details

I. General information

NPI: 1720632466
Provider Name (Legal Business Name): YELINA GORRITA PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6030 NW 186TH ST APT 103
HIALEAH FL
33015-8049
US

IV. Provider business mailing address

6030 NW 186TH ST APT 103
HIALEAH FL
33015-8049
US

V. Phone/Fax

Practice location:
  • Phone: 786-315-6313
  • Fax:
Mailing address:
  • Phone: 786-315-6313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-21-13046
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number18-52864
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: