Provider Demographics
NPI:1295538528
Name:VALDES IZQUIERDO, YAILEN (RBT)
Entity type:Individual
Prefix:
First Name:YAILEN
Middle Name:
Last Name:VALDES IZQUIERDO
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 CHICKEN FARM RD
Mailing Address - Street 2:
Mailing Address - City:OSTEEN
Mailing Address - State:FL
Mailing Address - Zip Code:32764-9233
Mailing Address - Country:US
Mailing Address - Phone:314-708-1667
Mailing Address - Fax:
Practice Address - Street 1:3840 SAINT JOHNS PKWY
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6370
Practice Address - Country:US
Practice Address - Phone:407-756-2703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician