Provider Demographics
NPI:1194114702
Name:CARDENAS ARAUJO, YELY
Entity type:Individual
Prefix:
First Name:YELY
Middle Name:
Last Name:CARDENAS ARAUJO
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 1:1024 MAINSAIL DR UNIT 512
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-7809
Mailing Address - Country:US
Mailing Address - Phone:786-915-0955
Mailing Address - Fax:
Practice Address - Street 1:1024 MAINSAIL DR UNIT 512
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-7809
Practice Address - Country:US
Practice Address - Phone:786-915-0955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
FL0-21-12589106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1194114702Medicaid
FL103370800Medicaid