Provider Demographics
NPI:1225724289
Name:HERNANDEZ PEREZ, YELENA
Entity type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:HERNANDEZ PEREZ
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 1:409 NE 6TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-1967
Mailing Address - Country:US
Mailing Address - Phone:737-802-2986
Mailing Address - Fax:
Practice Address - Street 1:409 NE 6TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-1967
Practice Address - Country:US
Practice Address - Phone:737-802-2986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-25-15992106E00000X
FL23-267924106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician