Provider Demographics
NPI:1396633947
Name:FLORES BRAVO, YESLI (CBHCMS0102813)
Entity type:Individual
Prefix:
First Name:YESLI
Middle Name:
Last Name:FLORES BRAVO
Suffix:
Gender:F
Credentials:CBHCMS0102813
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 SW 37TH LN
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-5851
Mailing Address - Country:US
Mailing Address - Phone:786-444-6583
Mailing Address - Fax:
Practice Address - Street 1:15305 NW 60TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2461
Practice Address - Country:US
Practice Address - Phone:786-536-7561
Practice Address - Fax:786-359-4066
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCMS.0102813104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker