Healthcare Provider Details

I. General information

NPI: 1891273553
Provider Name (Legal Business Name): YUDIT GUERRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2018
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 NW 44TH AVE APT 212
MIAMI FL
33126-3551
US

IV. Provider business mailing address

940 NW 44TH AVE APT 212
MIAMI FL
33126-3551
US

V. Phone/Fax

Practice location:
  • Phone: 786-657-5145
  • Fax:
Mailing address:
  • Phone: 786-657-5145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-15-06501
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: