Healthcare Provider Details

I. General information

NPI: 1235628249
Provider Name (Legal Business Name): MRS. DANIA TRISTA AGUILERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2018
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 W FLAGLER ST STE 215
CORAL GABLES FL
33134-1402
US

IV. Provider business mailing address

1408 BRICKELL BAY DR APT 604
MIAMI FL
33131-3623
US

V. Phone/Fax

Practice location:
  • Phone: 954-368-4786
  • Fax:
Mailing address:
  • Phone: 954-479-4115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-55117
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number18-54795
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: