Healthcare Provider Details

I. General information

NPI: 1053026260
Provider Name (Legal Business Name): YOUR NEIGHBOR MEDICAL GROUP CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13501 SW 128TH ST STE 114
MIAMI FL
33186-5014
US

IV. Provider business mailing address

13255 SW 137TH AVE STE 210
MIAMI FL
33186-5328
US

V. Phone/Fax

Practice location:
  • Phone: 786-250-3440
  • Fax: 786-364-1810
Mailing address:
  • Phone: 786-250-3440
  • Fax: 786-364-1810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: YANET FERNANDEZ
Title or Position: OWNER
Credential:
Phone: 786-899-8240