Healthcare Provider Details

I. General information

NPI: 1225486830
Provider Name (Legal Business Name): YANEISY BAEZ ARTELLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 03/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 SW 91ST PL
MIAMI FL
33174-2368
US

IV. Provider business mailing address

535 SW 91ST PL
MIAMI FL
33174-2368
US

V. Phone/Fax

Practice location:
  • Phone: 786-334-2043
  • Fax:
Mailing address:
  • Phone: 786-334-2043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15742
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLMHC15742
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: