Provider Demographics
NPI:1285243410
Name:VALDES, YOELKIS (HIS)
Entity type:Individual
Prefix:
First Name:YOELKIS
Middle Name:
Last Name:VALDES
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 8TH ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-7455
Mailing Address - Country:US
Mailing Address - Phone:239-498-7142
Mailing Address - Fax:
Practice Address - Street 1:15 8TH ST UNIT B
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-7455
Practice Address - Country:US
Practice Address - Phone:239-498-7142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5439237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist