Provider Demographics
NPI:1447052428
Name:NODA OTANO, YAINERIS (RBT)
Entity type:Individual
Prefix:
First Name:YAINERIS
Middle Name:
Last Name:NODA OTANO
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 1:324 PALMETTO DR
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-9450
Mailing Address - Country:US
Mailing Address - Phone:305-297-8681
Mailing Address - Fax:
Practice Address - Street 1:324 PALMETTO DR
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-9450
Practice Address - Country:US
Practice Address - Phone:305-297-8681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-421641106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician