Provider Demographics
NPI:1609183706
Name:CORTES, YOLANDA (RBT)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:CORTES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14709 GREEN VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-8549
Mailing Address - Country:US
Mailing Address - Phone:646-732-4265
Mailing Address - Fax:
Practice Address - Street 1:14709 GREEN VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-8549
Practice Address - Country:US
Practice Address - Phone:646-732-4265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0067941224Z00000X
FL19-74990106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant