MEDICARE: YISEL MARTINEZ VALLE

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	RBT-25-418258	FL
2	2355S0801X	Speech-Language Assistant	7953	FL

General Provider Information

NPI Number	:	1114712643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YISEL MARTINEZ VALLE

Provider Business Mailing Address
First Line	:	777 NW 72ND AVE STE 1083
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3176
Country	:	US
Telephone Number	:	786-490-6307
Fax Number	:

Provider Business Practice Location Address
First Line	:	17059 NW 60TH CT
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-4645
Country	:	US
Telephone Number	:	786-583-9992
Fax Number	:

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

Provider Enumeration Date	:	04/14/2025
Last Update Date	:	12/15/2025

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Directions to “ YISEL MARTINEZ VALLE ” Practice Location

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