Healthcare Provider Details

I. General information

NPI: 1467375253
Provider Name (Legal Business Name): NAYELI SOSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 NW 150TH AVE STE 2112
PEMBROKE PINES FL
33028-2870
US

IV. Provider business mailing address

10978 SW 243RD LN
HOMESTEAD FL
33032-5110
US

V. Phone/Fax

Practice location:
  • Phone: 754-264-8779
  • Fax:
Mailing address:
  • Phone: 786-925-3816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: