MEDICARE: YARETMY HERNANDEZ MORENO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1144061128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YARETMY HERNANDEZ MORENO

Provider Business Mailing Address
First Line	:	4051 SW 2ND TER
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1728
Country	:	US
Telephone Number	:	239-272-0474
Fax Number	:

Provider Business Practice Location Address
First Line	:	4051 SW 2ND TER
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1728
Country	:	US
Telephone Number	:	239-272-0474
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2024
Last Update Date	:	06/04/2024

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