Provider Demographics
NPI:1588351506
Name:NUNEZ LEYGONIER, YAHIMA
Entity type:Individual
Prefix:
First Name:YAHIMA
Middle Name:
Last Name:NUNEZ LEYGONIER
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 1:3012 W BRADDOCK ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-1256
Mailing Address - Country:US
Mailing Address - Phone:813-858-9219
Mailing Address - Fax:
Practice Address - Street 1:3012 W BRADDOCK ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1256
Practice Address - Country:US
Practice Address - Phone:813-858-9219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-266445106S00000X, 106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician