Provider Demographics
NPI:1972497394
Name:MEDINA ALBA, YOSLAY ALBERTO
Entity type:Individual
Prefix:
First Name:YOSLAY
Middle Name:ALBERTO
Last Name:MEDINA ALBA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12315 SW 151ST ST APT 114D
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-8710
Mailing Address - Country:US
Mailing Address - Phone:786-710-7454
Mailing Address - Fax:
Practice Address - Street 1:12315 SW 151ST ST APT 114D
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-8710
Practice Address - Country:US
Practice Address - Phone:786-710-7454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-435540106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician