Provider Demographics
NPI:1255945374
Name:VALDES REYES, YUDISLEIDY
Entity type:Individual
Prefix:
First Name:YUDISLEIDY
Middle Name:
Last Name:VALDES REYES
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 1:858 SE 17TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-3712
Mailing Address - Country:US
Mailing Address - Phone:786-368-7871
Mailing Address - Fax:
Practice Address - Street 1:858 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-3712
Practice Address - Country:US
Practice Address - Phone:786-368-7871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician