MEDICARE: YARISLEY HERNANDEZ CHAVEZ

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	RBT-24-322349	FL

General Provider Information

NPI Number	:	1427811967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YARISLEY HERNANDEZ CHAVEZ

Provider Business Mailing Address
First Line	:	18850 NW 57TH AVE APT 108
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-7020
Country	:	US
Telephone Number	:	786-440-8443
Fax Number	:

Provider Business Practice Location Address
First Line	:	480 E OCEAN AVE
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-4542
Country	:	US
Telephone Number	:	786-343-6741
Fax Number	:

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

Provider Enumeration Date	:	02/06/2024
Last Update Date	:	02/06/2024

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Directions to “ YARISLEY HERNANDEZ CHAVEZ ” Practice Location

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