Healthcare Provider Details

I. General information

NPI: 1730601048
Provider Name (Legal Business Name): ANDREA BEATRIZ DE AGUAYO LMHC, PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2017
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 PONCE DE LEON BLVD STE 332
CORAL GABLES FL
33134-2050
US

IV. Provider business mailing address

3625 NW 82ND AVE STE 400O
DORAL FL
33166-7602
US

V. Phone/Fax

Practice location:
  • Phone: 786-407-3375
  • Fax: 305-850-6729
Mailing address:
  • Phone: 305-926-2617
  • Fax: 305-850-6729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY10780
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH14214
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: