Healthcare Provider Details

I. General information

NPI: 1174418537
Provider Name (Legal Business Name): SAHYLI BALMASEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 SW 13TH ST
CAPE CORAL FL
33991-2318
US

IV. Provider business mailing address

1623 SW 13TH ST
CAPE CORAL FL
33991-2318
US

V. Phone/Fax

Practice location:
  • Phone: 305-224-0014
  • Fax:
Mailing address:
  • Phone: 239-244-5274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-439404
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: