Provider Demographics
NPI:1154953479
Name:VALDES, BETYLEIDIS (RBT-18-58208)
Entity type:Individual
Prefix:
First Name:BETYLEIDIS
Middle Name:
Last Name:VALDES
Suffix:
Gender:F
Credentials:RBT-18-58208
Other - Prefix:
Other - First Name:BETYLEIDIS
Other - Middle Name:
Other - Last Name:VALDES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5590 W 14TH LN
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2233
Mailing Address - Country:US
Mailing Address - Phone:786-510-9356
Mailing Address - Fax:
Practice Address - Street 1:12966 SW 133RD CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6173
Practice Address - Country:US
Practice Address - Phone:305-255-6203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-58208106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician