Provider Demographics
NPI:1578399135
Name:HERNANDEZ, YURISLEIDY FRANCIA
Entity type:Individual
Prefix:
First Name:YURISLEIDY
Middle Name:FRANCIA
Last Name:HERNANDEZ
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 1:93 W 27TH ST APT 8
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-1756
Mailing Address - Country:US
Mailing Address - Phone:754-284-2073
Mailing Address - Fax:
Practice Address - Street 1:93 W 27TH ST APT 8
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-1756
Practice Address - Country:US
Practice Address - Phone:754-284-2073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1077961106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician