Healthcare Provider Details

I. General information

NPI: 1093684854
Provider Name (Legal Business Name): YONAIKI VALDES LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5051 MEMORIAL HWY UNIT B
TAMPA FL
33634-7355
US

IV. Provider business mailing address

3002 25TH ST SW
LEHIGH ACRES FL
33976-4026
US

V. Phone/Fax

Practice location:
  • Phone: 813-290-0779
  • Fax: 813-290-0647
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-423799
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: