Provider Demographics
NPI:1952295446
Name:UGARDE, YANSELL C (SLP)
Entity type:Individual
Prefix:
First Name:YANSELL
Middle Name:C
Last Name:UGARDE
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15742 SW 138TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-6702
Mailing Address - Country:US
Mailing Address - Phone:786-365-8896
Mailing Address - Fax:
Practice Address - Street 1:15742 SW 138TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-6702
Practice Address - Country:US
Practice Address - Phone:786-365-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ12667235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist