Healthcare Provider Details

I. General information

NPI: 1437861341
Provider Name (Legal Business Name): YARIEL CACERES ROCUBERT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14945 LEISURE DR
HOMESTEAD FL
33033-2740
US

IV. Provider business mailing address

14945 LEISURE DR
HOMESTEAD FL
33033-2740
US

V. Phone/Fax

Practice location:
  • Phone: 786-650-9259
  • Fax:
Mailing address:
  • Phone: 786-650-9259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90373
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: