Healthcare Provider Details

I. General information

NPI: 1316821804
Provider Name (Legal Business Name): YANELY GONZALEZ CESPEDES YGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1656 21ST ST # 1-306
SARASOTA FL
34234-8501
US

IV. Provider business mailing address

1656 21ST ST # 1-306
SARASOTA FL
34234-8501
US

V. Phone/Fax

Practice location:
  • Phone: 941-250-7180
  • Fax:
Mailing address:
  • Phone: 941-250-7180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-455739
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: