Provider Demographics
NPI:1891513354
Name:DIAZ BENITEZ, YANELYS (RBT)
Entity type:Individual
Prefix:
First Name:YANELYS
Middle Name:
Last Name:DIAZ BENITEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 NORTHBROOKE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-8099
Mailing Address - Country:US
Mailing Address - Phone:239-465-3546
Mailing Address - Fax:239-325-9478
Practice Address - Street 1:2575 NORTHBROOKE PLAZA DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-8099
Practice Address - Country:US
Practice Address - Phone:239-465-3546
Practice Address - Fax:239-325-9478
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-363791106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician