Provider Demographics
NPI:1023644739
Name:LASSALLE, YOSLAY
Entity type:Individual
Prefix:
First Name:YOSLAY
Middle Name:
Last Name:LASSALLE
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 1:14600 SW 296TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-2970
Mailing Address - Country:US
Mailing Address - Phone:786-379-3895
Mailing Address - Fax:
Practice Address - Street 1:14600 SW 296TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-2970
Practice Address - Country:US
Practice Address - Phone:786-379-3895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-14
Last Update Date:2020-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator