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General NPI Number Information
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NPI Number | 1992097471
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Entity Type | Organization
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Legal Business Name | YANEVERT SERVICES , CORP
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Dates
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Enumeration Date | 05/03/2011
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Last Update Date | 05/03/2011
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Provider Practice Location Address
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Address Line | 21130 SW 87TH AVE APT 202
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City | CUTLER BAY
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State | FL
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Zip | 33189-7387
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Country | US
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Telephone | 786-252-2256
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Fax |
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Provider Business Mailing Address
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Address Line | 21130 SW 87TH AVE APT 202
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City | CUTLER BAY
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State | FL
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Zip | 33189-7387
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Country | US
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Telephone | 786-252-2256
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Fax |
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Authorized Official
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Title or Position | THERAPIES
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Name | MRS. YANELYS FUNDORA
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Credential | LMT
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Telephone | 786-252-2256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number | MA58827
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License Number State | FL
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