Provider Demographics
NPI:1306658547
Name:VARONA, YANISBEL
Entity type:Individual
Prefix:
First Name:YANISBEL
Middle Name:
Last Name:VARONA
Suffix:
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 1:1805 NW 17THTER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993
Mailing Address - Country:US
Mailing Address - Phone:239-321-9762
Mailing Address - Fax:
Practice Address - Street 1:1805 NW 17THTER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-2910
Practice Address - Country:US
Practice Address - Phone:239-321-9762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1150893106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician