Provider Demographics
NPI:1114520145
Name:SERRANO MARRERO, YANET
Entity type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:SERRANO MARRERO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6291 SAVANNAH BREEZE CT APT 205
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-1107
Mailing Address - Country:US
Mailing Address - Phone:813-230-5588
Mailing Address - Fax:
Practice Address - Street 1:2511 W VIRGINIA AVE STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6310
Practice Address - Country:US
Practice Address - Phone:813-666-8214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-23-14293106E00000X
FL1-25-79239103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst