Healthcare Provider Details

I. General information

NPI: 1770930448
Provider Name (Legal Business Name): YANET PEREZ ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2016
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11890 SW 8TH ST SUITE 309
MIAMI FL
33184-1743
US

IV. Provider business mailing address

4906 SW 137TH CT
MIAMI FL
33175-5136
US

V. Phone/Fax

Practice location:
  • Phone: 305-220-6060
  • Fax: 888-247-5059
Mailing address:
  • Phone: 786-803-6168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11018601
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: