MEDICARE: REINA ISSEL VALDEZ

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	18-49145	FL
2	103K00000X	Behavior Analyst	1-19-40388	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477078657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REINA ISSEL VALDEZ

Provider Business Mailing Address
First Line	:	1503 15TH LN
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-4359
Country	:	US
Telephone Number	:	561-294-6247
Fax Number	:

Provider Business Practice Location Address
First Line	:	1503 15TH LN
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-4359
Country	:	US
Telephone Number	:	561-294-6247
Fax Number	:

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

Provider Enumeration Date	:	08/08/2017
Last Update Date	:	03/26/2023

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Directions to “ REINA ISSEL VALDEZ ” Practice Location

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