Healthcare Provider Details

I. General information

NPI: 1083169858
Provider Name (Legal Business Name): YENNY HORRACH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2016
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9241 ANDORA DR
MIRAMAR FL
33025-2468
US

IV. Provider business mailing address

9241 ANDORA DR
MIRAMAR FL
33025-2468
US

V. Phone/Fax

Practice location:
  • Phone: 786-439-7040
  • Fax:
Mailing address:
  • Phone: 786-439-7040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-54803
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: