Provider Demographics
NPI:1902693070
Name:OCAMPO PUPO, YURLEIVYS
Entity type:Individual
Prefix:
First Name:YURLEIVYS
Middle Name:
Last Name:OCAMPO PUPO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 27TH PL SW UNIT B
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-7657
Mailing Address - Country:US
Mailing Address - Phone:239-207-7304
Mailing Address - Fax:
Practice Address - Street 1:5001 27TH PL SW UNIT B
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-7657
Practice Address - Country:US
Practice Address - Phone:239-207-7304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLRBT-25-430314106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician