Provider Demographics
NPI:1497525893
Name:ARADO CEBALLOS, YAILYN CARIDAD
Entity type:Individual
Prefix:
First Name:YAILYN
Middle Name:CARIDAD
Last Name:ARADO CEBALLOS
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 1:1307 SE 24TH ST FL 33990
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-4632
Mailing Address - Country:US
Mailing Address - Phone:386-205-3761
Mailing Address - Fax:
Practice Address - Street 1:1307 SE 24TH ST FL 33990
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-4632
Practice Address - Country:US
Practice Address - Phone:386-205-3761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-05
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-311286106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician