Provider Demographics
NPI:1194595496
Name:ROJAS COLUMBIE, YAIMET SR
Entity type:Individual
Prefix:
First Name:YAIMET
Middle Name:
Last Name:ROJAS COLUMBIE
Suffix:SR
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 1:2972 DERBY AVE SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-7647
Mailing Address - Country:US
Mailing Address - Phone:786-212-9132
Mailing Address - Fax:
Practice Address - Street 1:2972 DERBY AVE SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-7647
Practice Address - Country:US
Practice Address - Phone:786-212-9132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1033714106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician