MEDICARE: YUSILY RAMOS RIVERO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT1857481	FL
2	103K00000X	Behavior Analyst
3	103K00000X	Behavior Analyst	BCBA1-21-53436	FL

General Provider Information

NPI Number	:	1053955930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUSILY RAMOS RIVERO

Provider Business Mailing Address
First Line	:	601 LUDLAND DR APT 4
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-4971
Country	:	US
Telephone Number	:	786-612-2328
Fax Number	:

Provider Business Practice Location Address
First Line	:	7535 COCONUT BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33412-2269
Country	:	US
Telephone Number	:	786-612-2328
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2019
Last Update Date	:	01/25/2026

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