Healthcare Provider Details

I. General information

NPI: 1952087553
Provider Name (Legal Business Name): YANDRO JESUS SAEZ SANCHEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12780 SW 65TH ST
MIAMI FL
33183-1309
US

IV. Provider business mailing address

12780 SW 65TH ST
MIAMI FL
33183-1309
US

V. Phone/Fax

Practice location:
  • Phone: 305-345-1783
  • Fax:
Mailing address:
  • Phone: 305-345-1783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90125
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: