Provider Demographics
NPI:1073230892
Name:MARTINEZ MESTRE, YAILY (RBT)
Entity Type:Individual
Prefix:
First Name:YAILY
Middle Name:
Last Name:MARTINEZ MESTRE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:YAILY
Other - Middle Name:
Other - Last Name:MARTINEZ MESTRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:9100 SW 183RD TER
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5954
Mailing Address - Country:US
Mailing Address - Phone:786-317-4925
Mailing Address - Fax:
Practice Address - Street 1:9100 SW 183RD TER
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-5954
Practice Address - Country:US
Practice Address - Phone:786-317-4925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician