Provider Demographics
NPI:1699286112
Name:ROJAS DIAZ, YUDELKIS
Entity type:Individual
Prefix:MRS
First Name:YUDELKIS
Middle Name:
Last Name:ROJAS DIAZ
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 1:3210 EVERETT ST
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-6019
Mailing Address - Country:US
Mailing Address - Phone:787-484-4940
Mailing Address - Fax:
Practice Address - Street 1:3210 EVERETT ST
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-6019
Practice Address - Country:US
Practice Address - Phone:787-484-4940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst