Provider Demographics
NPI:1497525893
Name:ARADO CEBALLOS, YAILYN CARIDAD
Entity Type:Individual
Prefix:
First Name:YAILYN
Middle Name:CARIDAD
Last Name:ARADO CEBALLOS
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 1:810 PEARL AVE SE
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32064-3822
Mailing Address - Country:US
Mailing Address - Phone:138-620-5376
Mailing Address - Fax:
Practice Address - Street 1:810 PEARL AVE SE
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32064-3822
Practice Address - Country:US
Practice Address - Phone:138-620-5376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-311286106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician