Provider Demographics
NPI:1316708530
Name:CARRAZANA GUERRA, YAMICEL
Entity type:Individual
Prefix:
First Name:YAMICEL
Middle Name:
Last Name:CARRAZANA GUERRA
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 1:490 W 29TH PL APT 407
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5351
Mailing Address - Country:US
Mailing Address - Phone:786-696-9871
Mailing Address - Fax:
Practice Address - Street 1:5881 NW 151ST ST STE 127
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2442
Practice Address - Country:US
Practice Address - Phone:786-905-2262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-314685106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician