Provider Demographics
NPI:1689555971
Name:FERNANDEZ PEREZ, YENISBEL (RBT)
Entity type:Individual
Prefix:
First Name:YENISBEL
Middle Name:
Last Name:FERNANDEZ PEREZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15800 BULL RUN RD APT 356F
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2138
Mailing Address - Country:US
Mailing Address - Phone:786-717-8486
Mailing Address - Fax:
Practice Address - Street 1:15800 BULL RUN RD APT 356F
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2138
Practice Address - Country:US
Practice Address - Phone:786-717-8486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-471594106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty