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General NPI Number Information
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NPI Number | 1265241970
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Entity Type | Individual
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Provider Name | GEIDY VICTORIA OLIVA YANEZ
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Gender | Female
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 321 SW 21ST ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33315-2508
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Country | US
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Telephone | 954-540-0170
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Fax |
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Provider Business Mailing Address
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Address Line | 2435 W 12TH AVE APT 3
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City | HIALEAH
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State | FL
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Zip | 33010-1857
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Country | US
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Telephone | 786-681-9796
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-20-118160
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License Number State | FL
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