Individual provider Active NPI

Yaailen Puebla Vazquez

  • Behavior Technician
  • Greenacres, FL
National Provider Identifier
1821805748
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
24-379675 Issued in FL
Practice address
308 Fleming Ave
Greenacres, FL 33463-3312
Phone
(561) 603-9602
NPI assigned
Dec 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 24-379675 FL Primary

Addresses

Primary practice location

308 Fleming Ave
Greenacres, FL 33463-3312

Mailing address

308 Fleming Ave
Greenacres, FL 33463-3312
Phone (561) 603-9602

Other names 1

  • Yaailen Puebla Vazquez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
24-379675FLMDBehavior Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1821805748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 FLEMING AVE",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633312",
            "telephone_number": "561-603-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 FLEMING AVE",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633312",
            "telephone_number": "561-603-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUEBLA VAZQUEZ",
        "first_name": "YAAILEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "24-379675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YAAILEN",
            "last_name": "PUEBLA VAZQUEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenacres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.