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NPI Code Detail

MEDICARE: YADIRA HUEZO

MEDICARE: YADIRA HUEZO
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
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1447616701
Entity Type Code : Individual
Provider Name (Legal Business Name) : YADIRA HUEZO
Provider Business Mailing Address
First Line : 500 FAIRWAY DR
Second Line : SUITE 102
City : DEERFIELD BEACH
State : FL
Zip : 33441-1814
Country : US
Telephone Number : 888-880-9270
Fax Number :
Provider Business Practice Location Address
First Line : 560 HAIGHT ST
Second Line : #104
City : SAN FRANCISCO
State : CA
Zip : 94117-3431
Country : US
Telephone Number : 954-603-7885
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2016
Last Update Date : 01/01/2016

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Directions to “ YADIRA HUEZO ” Practice Location

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