Healthcare Provider Details

I. General information

NPI: 1639916778
Provider Name (Legal Business Name): YULEIVY GUTIERREZ GARCIA RBT-24-361652
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 WINTERS ST E
LEHIGH ACRES FL
33974-2701
US

IV. Provider business mailing address

923 WINTERS ST E
LEHIGH ACRES FL
33974-2701
US

V. Phone/Fax

Practice location:
  • Phone: 561-324-4504
  • Fax:
Mailing address:
  • Phone: 561-324-4504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-361652
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: