Provider Demographics
NPI:1174228829
Name:ALONSO, YURIDEYSI (RBT)
Entity type:Individual
Prefix:
First Name:YURIDEYSI
Middle Name:
Last Name:ALONSO
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 1:7713 W HIAWATHA ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3311
Mailing Address - Country:US
Mailing Address - Phone:656-204-6058
Mailing Address - Fax:
Practice Address - Street 1:1202 TECH BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-7871
Practice Address - Country:US
Practice Address - Phone:813-470-9566
Practice Address - Fax:844-220-9322
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT25442027106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT25442027OtherBACB