MEDICARE: YANETSY FIALLO CBHCMS

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	171M00000X	Case Manager/Care Coordinator

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	:	1881045516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANETSY FIALLO CBHCMS

Provider Business Mailing Address
First Line	:	19130 NW 80TH CT
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5211
Country	:	US
Telephone Number	:	786-302-3162
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 W 84TH ST STE 406
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-5780
Country	:	US
Telephone Number	:	786-302-3162
Fax Number	:	786-398-5500

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

Provider Enumeration Date	:	06/23/2016
Last Update Date	:	12/18/2023

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Directions to “ YANETSY FIALLO CBHCMS” Practice Location

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