Provider Demographics
NPI:1619611332
Name:TORNA VALIDO, ISMELYS
Entity Type:Individual
Prefix:MISS
First Name:ISMELYS
Middle Name:
Last Name:TORNA VALIDO
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 1:11630 SW 125TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4924
Mailing Address - Country:US
Mailing Address - Phone:786-616-9390
Mailing Address - Fax:
Practice Address - Street 1:1701 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2098
Practice Address - Country:US
Practice Address - Phone:786-467-7006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT22210675106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician