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General NPI Number Information
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NPI Number | 1669185179
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Entity Type | Individual
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Provider Name | YORDANKA MARTINEZ MILLARES
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Gender | Female
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Dates
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Enumeration Date | 12/29/2022
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 1825 NW CORPORATE BLVD
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City | BOCA RATON
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State | FL
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Zip | 33431-8554
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Country | US
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Telephone | 561-710-3135
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Fax | 561-710-3136
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Provider Business Mailing Address
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Address Line | 7818 RIDGEWOOD DR
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City | LAKE WORTH
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State | FL
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Zip | 33467-6332
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Country | US
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Telephone | 561-860-1560
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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-22-249000
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License Number State | FL
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