Healthcare Provider Details

I. General information

NPI: 1518597830
Provider Name (Legal Business Name): YULIET MOYA-MENA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2020
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11805 SW 11TH ST
MIAMI FL
33184-2501
US

IV. Provider business mailing address

11805 SW 11TH ST
MIAMI FL
33184-2501
US

V. Phone/Fax

Practice location:
  • Phone: 786-525-5776
  • Fax:
Mailing address:
  • Phone: 786-525-5776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number100900
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-56700
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: