Provider Demographics
NPI:1669210910
Name:NAVARRO DIAZ, YARELIS CARIDAD (RBT)
Entity type:Individual
Prefix:
First Name:YARELIS
Middle Name:CARIDAD
Last Name:NAVARRO DIAZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5970 NW 114TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6522
Mailing Address - Country:US
Mailing Address - Phone:754-946-6499
Mailing Address - Fax:
Practice Address - Street 1:7900 NW 155TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5898
Practice Address - Country:US
Practice Address - Phone:786-536-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-330326106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty