Healthcare Provider Details

I. General information

NPI: 1427660232
Provider Name (Legal Business Name): YAIMA ALVAREZ CARDERO CBHCMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11401 SW 40TH ST STE 345
MIAMI FL
33165-3372
US

IV. Provider business mailing address

1780 SW 139TH PL
MIAMI FL
33175-7071
US

V. Phone/Fax

Practice location:
  • Phone: 305-603-7063
  • Fax: 305-603-8705
Mailing address:
  • Phone: 786-619-5639
  • Fax: 954-807-8957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: