MEDICARE: YARISLEIDY PEREZ DELGADO

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-25-468459	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RBT-25-468459	OTHER	FL	BACB

General Provider Information

NPI Number	:	1154293256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YARISLEIDY PEREZ DELGADO

Provider Business Mailing Address
First Line	:	8241 SW 3RD ST
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-1003
Country	:	US
Telephone Number	:	305-407-4572
Fax Number	:

Provider Business Practice Location Address
First Line	:	8241 SW 3RD ST
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-1003
Country	:	US
Telephone Number	:	305-407-4572
Fax Number	:

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

Provider Enumeration Date	:	09/19/2025
Last Update Date	:	09/19/2025

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