MEDICARE: YAIMA RODRIGUEZ CAPOTE

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-24-388386	FL

General Provider Information

NPI Number	:	1942024153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAIMA RODRIGUEZ CAPOTE

Provider Business Mailing Address
First Line	:	2760 W 76TH ST APT 106
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-5619
Country	:	US
Telephone Number	:	941-536-8109
Fax Number	:

Provider Business Practice Location Address
First Line	:	2760 W 76TH ST APT 106
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-5619
Country	:	US
Telephone Number	:	941-536-8109
Fax Number	:

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

Provider Enumeration Date	:	11/13/2024
Last Update Date	:	11/13/2024

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Directions to “ YAIMA RODRIGUEZ CAPOTE ” Practice Location

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