Healthcare Provider Details

I. General information

NPI: 1669096954
Provider Name (Legal Business Name): YALINA GUERRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2020
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13431 SW 62ND ST APT 1
MIAMI FL
33183-5133
US

IV. Provider business mailing address

13431 SW 62ND ST APT 1
MIAMI FL
33183-5133
US

V. Phone/Fax

Practice location:
  • Phone: 305-801-5987
  • Fax:
Mailing address:
  • Phone: 305-801-5987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-69627
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-120312
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: