Provider Demographics
NPI:1215424031
Name:RIOS DEL VALLIN, YULEIDYS
Entity type:Individual
Prefix:MRS
First Name:YULEIDYS
Middle Name:
Last Name:RIOS DEL VALLIN
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 1:10975 SW 214TH ST APT 208
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3150
Mailing Address - Country:US
Mailing Address - Phone:305-984-7110
Mailing Address - Fax:
Practice Address - Street 1:10975 SW 214TH ST APT 208
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33189-3150
Practice Address - Country:US
Practice Address - Phone:305-984-7110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID023262700Medicaid