MEDICARE: VYM@X

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	106E00000X	Assistant Behavior Analyst

General Provider Information

NPI Number	:	1639026065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VYM@X

Provider Business Mailing Address
First Line	:	4006 GREENWOOD DR
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6151
Country	:	US
Telephone Number	:	305-450-1969
Fax Number	:

Provider Business Practice Location Address
First Line	:	4006 GREENWOOD DR
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6151
Country	:	US
Telephone Number	:	305-450-1969
Fax Number	:

Authorized Official
Title or Position	:	BCABA
Name	:	YURELIS GONZALEZ
Credential	:
Telephone Number	:	305-450-1969

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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Directions to “VYM@X ” Practice Location

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