Healthcare Provider Details

I. General information

NPI: 1891573739
Provider Name (Legal Business Name): YANISLEIDY YERA FERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5425 GOLDEN GATE PKWY
NAPLES FL
34116-7524
US

IV. Provider business mailing address

161 13TH ST SW
NAPLES FL
34117-2146
US

V. Phone/Fax

Practice location:
  • Phone: 239-778-8455
  • Fax:
Mailing address:
  • Phone: 239-324-7930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: