Healthcare Provider Details

I. General information

NPI: 1285152942
Provider Name (Legal Business Name): YANET FERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2017
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 ELDEN ST STE 302
HERNDON VA
20170-4851
US

IV. Provider business mailing address

16035 SW 97TH AVE
MIAMI FL
33157-3305
US

V. Phone/Fax

Practice location:
  • Phone: 703-496-4371
  • Fax:
Mailing address:
  • Phone: 305-815-7984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-53018
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133003507
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: