Healthcare Provider Details

I. General information

NPI: 1881372183
Provider Name (Legal Business Name): SHEILA AREVALO MIRANDA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5051 MEMORIAL HWY UNIT B
TAMPA FL
33634-7355
US

IV. Provider business mailing address

1714 NW 17TH ST
CAPE CORAL FL
33993-4907
US

V. Phone/Fax

Practice location:
  • Phone: 813-290-0779
  • Fax:
Mailing address:
  • Phone: 754-667-9189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88965
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: