Provider Demographics
NPI:1679381552
Name:ESPINOSA TORNES, YENISEIDIS
Entity type:Individual
Prefix:
First Name:YENISEIDIS
Middle Name:
Last Name:ESPINOSA TORNES
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 1:9431 BIRMINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-5927
Mailing Address - Country:US
Mailing Address - Phone:561-875-9965
Mailing Address - Fax:
Practice Address - Street 1:9431 BIRMINGHAM DR
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-5927
Practice Address - Country:US
Practice Address - Phone:561-875-9965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-399151106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician