Healthcare Provider Details

I. General information

NPI: 1962311662
Provider Name (Legal Business Name): AMY VILALTA ABREU
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18771 LENAIRE DR
CUTLER BAY FL
33157-6954
US

IV. Provider business mailing address

18771 LENAIRE DR
CUTLER BAY FL
33157-6954
US

V. Phone/Fax

Practice location:
  • Phone: 786-450-8189
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: