Provider Demographics
NPI:1619412152
Name:DELVALLE-OQUENDO, EFRED DAVID (RBT)
Entity Type:Individual
Prefix:MR
First Name:EFRED
Middle Name:DAVID
Last Name:DELVALLE-OQUENDO
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8713 CAMBOURNE WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-3992
Mailing Address - Country:US
Mailing Address - Phone:407-844-2381
Mailing Address - Fax:
Practice Address - Street 1:8617 E COLONIAL DR
Practice Address - Street 2:SUITE 1100
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-3938
Practice Address - Country:US
Practice Address - Phone:407-895-0801
Practice Address - Fax:407-895-0803
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician