Healthcare Provider Details

I. General information

NPI: 1306755194
Provider Name (Legal Business Name): YANET MONTEAGUDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 E OCEAN AVE
BOYNTON BEACH FL
33435-4542
US

IV. Provider business mailing address

9731 SW 145TH AVE
MIAMI FL
33186-6931
US

V. Phone/Fax

Practice location:
  • Phone: 786-343-6741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-536869
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: