Healthcare Provider Details

I. General information

NPI: 1629743984
Provider Name (Legal Business Name): YOLEMNY RIVERA LOREDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4604 SW 144TH CT
MIAMI FL
33175-6942
US

IV. Provider business mailing address

4604 SW 144TH CT
MIAMI FL
33175-6942
US

V. Phone/Fax

Practice location:
  • Phone: 305-582-4222
  • Fax:
Mailing address:
  • Phone: 305-582-4222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-157976
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: