Provider Demographics
NPI:1548627003
Name:MARIN, YUSNIEL (MA)
Entity type:Individual
Prefix:MR
First Name:YUSNIEL
Middle Name:
Last Name:MARIN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6223 SW 158TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3609
Mailing Address - Country:US
Mailing Address - Phone:786-281-5820
Mailing Address - Fax:
Practice Address - Street 1:8181 NW 36TH ST STE 31
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6649
Practice Address - Country:US
Practice Address - Phone:305-418-2385
Practice Address - Fax:305-418-1888
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FL67840225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker