Healthcare Provider Details

I. General information

NPI: 1174833156
Provider Name (Legal Business Name): YAHIMA OQUENDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YAHIMA VARELA

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17400 SW 267TH LN
HOMESTEAD FL
33031-2336
US

IV. Provider business mailing address

14525 SW 56TH TER
MIAMI FL
33183-1020
US

V. Phone/Fax

Practice location:
  • Phone: 305-910-5057
  • Fax:
Mailing address:
  • Phone: 305-297-7790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: