Healthcare Provider Details

I. General information

NPI: 1023973484
Provider Name (Legal Business Name): YANET SANCHEZ MEDRANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4727 W IRLO BRONSON MEMORIAL HWY
KISSIMMEE FL
34746-5326
US

IV. Provider business mailing address

16913 LONE OAK CIR
ORLANDO FL
32832-4028
US

V. Phone/Fax

Practice location:
  • Phone: 321-972-4039
  • Fax:
Mailing address:
  • Phone: 407-984-0042
  • Fax: 407-984-0042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: