MEDICARE: YOSLANYS LOPEZ 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

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	:	1568106540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOSLANYS LOPEZ VALLE

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8090 W 28TH CT UNIT 204
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-7276
Country	:	US
Telephone Number	:	786-308-7030
Fax Number	:

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

Provider Enumeration Date	:	04/25/2022
Last Update Date	:	04/25/2022

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Directions to “ YOSLANYS LOPEZ VALLE ” Practice Location

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