MEDICARE: YANET VILLANUEVA SALCEDO

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

General Provider Information

NPI Number	:	1447783428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANET VILLANUEVA SALCEDO

Provider Business Mailing Address
First Line	:	1518 E MOWRY DR APTO 206
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33033
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1518 E MOWRY DR APT 206
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33033-4926
Country	:	US
Telephone Number	:	786-362-3987
Fax Number	:

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

Provider Enumeration Date	:	04/06/2017
Last Update Date	:	04/06/2017

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Directions to “ YANET VILLANUEVA SALCEDO ” Practice Location

Language	Start Address	Practice Location

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