Provider Demographics
NPI:1225568397
Name:VALERO, ILEANA
Entity Type:Individual
Prefix:MRS
First Name:ILEANA
Middle Name:
Last Name:VALERO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ILEANA
Other - Middle Name:
Other - Last Name:VALERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 SW 113TH AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1188
Mailing Address - Country:US
Mailing Address - Phone:786-678-8536
Mailing Address - Fax:
Practice Address - Street 1:31 SW 113TH AVE APT 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1188
Practice Address - Country:US
Practice Address - Phone:786-678-8536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician