Healthcare Provider Details

I. General information

NPI: 1053155812
Provider Name (Legal Business Name): YN HEALTH CARE SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18161 SW 134TH CT
MIAMI FL
33177-7131
US

IV. Provider business mailing address

18161 SW 134TH CT
MIAMI FL
33177-7131
US

V. Phone/Fax

Practice location:
  • Phone: 786-551-8253
  • Fax: 786-429-1770
Mailing address:
  • Phone: 786-551-8253
  • Fax: 786-429-1770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER MONTEAGUDO
Title or Position: PRESIDENT
Credential:
Phone: 786-551-8253