Provider Demographics
NPI:1255008611
Name:VALERO REYES, MERYLYN YURLEY
Entity Type:Individual
Prefix:
First Name:MERYLYN
Middle Name:YURLEY
Last Name:VALERO REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5840 BOVINE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-9138
Mailing Address - Country:US
Mailing Address - Phone:407-946-1585
Mailing Address - Fax:
Practice Address - Street 1:5840 BOVINE DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-9138
Practice Address - Country:US
Practice Address - Phone:407-946-1585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist