Provider Demographics
NPI:1386510550
Name:AMADOR FABELO, YOEL A
Entity type:Individual
Prefix:
First Name:YOEL
Middle Name:A
Last Name:AMADOR FABELO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22121 SW 124TH AVE
Mailing Address - Street 2:
Mailing Address - City:GOULDS
Mailing Address - State:FL
Mailing Address - Zip Code:33170-2709
Mailing Address - Country:US
Mailing Address - Phone:786-407-7106
Mailing Address - Fax:
Practice Address - Street 1:22121 SW 124TH AVE
Practice Address - Street 2:
Practice Address - City:GOULDS
Practice Address - State:FL
Practice Address - Zip Code:33170-2709
Practice Address - Country:US
Practice Address - Phone:786-407-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-473790106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician