Provider Demographics
NPI:1992097471
Name:YANEVERT SERVICES , CORP
Entity type:Organization
Organization Name:YANEVERT SERVICES , CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIES
Authorized Official - Prefix:MRS
Authorized Official - First Name:YANELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNDORA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-252-2256
Mailing Address - Street 1:21130 SW 87TH AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-7387
Mailing Address - Country:US
Mailing Address - Phone:786-252-2256
Mailing Address - Fax:
Practice Address - Street 1:21130 SW 87TH AVE APT 202
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-7387
Practice Address - Country:US
Practice Address - Phone:786-252-2256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA58827261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)