Basic Information
Provider Information
NPI: 1215360565
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DEL REY
FirstName: YAMILE
MiddleName:  
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Mailing Information
Address1: 7800 SW 57 AVE
Address2: SUITE 228
City: SOUTH MIAMI
State: FL
PostalCode: 331435523
CountryCode: US
TelephoneNumber: 3056654999
FaxNumber: 3056650332
Practice Location
Address1: 7800 SW 57TH AVE
Address2: SUITE 228
City: SOUTH MIAMI
State: FL
PostalCode: 331435528
CountryCode: US
TelephoneNumber: 3056654999
FaxNumber: 3056650332
Other Information
ProviderEnumerationDate: 08/09/2013
LastUpdateDate: 05/31/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate: 05/31/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106S00000XRBT-21-155675FLN    
222Q00000X FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist 

No ID Information.


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