Provider Demographics
NPI:1417770611
Name:DELGADO DIEZ, YEILAN
Entity type:Individual
Prefix:
First Name:YEILAN
Middle Name:
Last Name:DELGADO DIEZ
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 1:7403 W 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1795
Mailing Address - Country:US
Mailing Address - Phone:786-366-1407
Mailing Address - Fax:
Practice Address - Street 1:7403 W 35TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-1795
Practice Address - Country:US
Practice Address - Phone:786-366-1407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician