Healthcare Provider Details

I. General information

NPI: 1841136165
Provider Name (Legal Business Name): YISE NORA RUBIO MARQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7255 W 24TH AVE APT 101
HIALEAH FL
33016-6547
US

IV. Provider business mailing address

12905 SW 132ND ST STE 1
MIAMI FL
33186-6293
US

V. Phone/Fax

Practice location:
  • Phone: 305-794-9395
  • Fax:
Mailing address:
  • Phone: 305-342-7643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-529789
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: