Provider Demographics
NPI:1538669064
Name:RELOBA BETANCOURT, YUMILA
Entity Type:Individual
Prefix:
First Name:YUMILA
Middle Name:
Last Name:RELOBA BETANCOURT
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 1:14205 SW 91ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7803
Mailing Address - Country:US
Mailing Address - Phone:786-470-4722
Mailing Address - Fax:
Practice Address - Street 1:14205 SW 91ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7803
Practice Address - Country:US
Practice Address - Phone:786-470-4722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician