Provider Demographics
NPI:1871336818
Name:PRADO PINO, YAISEL (RBT)
Entity type:Individual
Prefix:
First Name:YAISEL
Middle Name:
Last Name:PRADO PINO
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 1:12801 SW 43RD DR APT 206A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-4162
Mailing Address - Country:US
Mailing Address - Phone:786-940-0536
Mailing Address - Fax:
Practice Address - Street 1:12801 SW 43RD DR APT 206A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-4162
Practice Address - Country:US
Practice Address - Phone:786-940-0536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-354865106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician