Provider Demographics
NPI:1043025182
Name:BRITO GARCIA, YUDIANELA CARIDAD
Entity type:Individual
Prefix:
First Name:YUDIANELA
Middle Name:CARIDAD
Last Name:BRITO GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 46TH ST N APT 6
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714-3464
Mailing Address - Country:US
Mailing Address - Phone:727-479-6246
Mailing Address - Fax:
Practice Address - Street 1:4500 46TH ST N APT 6
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33714-3464
Practice Address - Country:US
Practice Address - Phone:727-479-6246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-398034106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician