Provider Demographics
NPI:1194510388
Name:PEREZ HERRERA, YELENIS
Entity type:Individual
Prefix:
First Name:YELENIS
Middle Name:
Last Name:PEREZ HERRERA
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 1:1750 W 46TH ST APT 539
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2876
Mailing Address - Country:US
Mailing Address - Phone:786-983-0157
Mailing Address - Fax:
Practice Address - Street 1:1140 W 50TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3440
Practice Address - Country:US
Practice Address - Phone:305-231-3371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25427089106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician