Provider Demographics
NPI:1366133969
Name:CASANOVA GUERRA, YAINIER
Entity type:Individual
Prefix:
First Name:YAINIER
Middle Name:
Last Name:CASANOVA GUERRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3945 NW 207TH STREET RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-1142
Mailing Address - Country:US
Mailing Address - Phone:239-276-4680
Mailing Address - Fax:
Practice Address - Street 1:3945 NW 207TH STREET RD
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-1142
Practice Address - Country:US
Practice Address - Phone:239-276-4680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No374U00000XNursing Service Related ProvidersHome Health Aide