MEDICARE: YELENA HERNANDEZ PEREZ

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	103K00000X	Behavior Analyst	1-26-88383	FL
2	106S00000X	Behavior Technician	23-267924	FL
3	106E00000X	Assistant Behavior Analyst	0-25-15992	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225724289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YELENA HERNANDEZ PEREZ

Provider Business Mailing Address
First Line	:	409 NE 6TH TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-1967
Country	:	US
Telephone Number	:	737-802-2986
Fax Number	:

Provider Business Practice Location Address
First Line	:	409 NE 6TH TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-1967
Country	:	US
Telephone Number	:	737-802-2986
Fax Number	:

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

Provider Enumeration Date	:	04/13/2023
Last Update Date	:	03/30/2026

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