Healthcare Provider Details

I. General information

NPI: 1659988145
Provider Name (Legal Business Name): YEBELICE AURORA ARENAS BRAVO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2020
Last Update Date: 09/28/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6303 SW 40TH ST
MIAMI FL
33155-4825
US

IV. Provider business mailing address

8860 FONTAINEBLEAU BLVD APT 105
MIAMI FL
33172-4439
US

V. Phone/Fax

Practice location:
  • Phone: 786-620-6948
  • Fax: 954-206-0906
Mailing address:
  • Phone: 786-210-9810
  • Fax:

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: