Healthcare Provider Details

I. General information

NPI: 1497470702
Provider Name (Legal Business Name): MARIA VICTORIA DE VALES OLIVEROS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 GLADES RD STE 324A
BOCA RATON FL
33431-8571
US

IV. Provider business mailing address

17164 SW 112TH CT
MIAMI FL
33157-3907
US

V. Phone/Fax

Practice location:
  • Phone: 305-776-0296
  • Fax:
Mailing address:
  • Phone: 786-438-8481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-140501
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: