Healthcare Provider Details

I. General information

NPI: 1215664792
Provider Name (Legal Business Name): AIDA MARY OSSORIO MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2022
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 NW 41ST STREET SUITE 200
DORAL FL
33166-6204
US

IV. Provider business mailing address

6868 W 17TH CT
HIALEAH FL
33014-4415
US

V. Phone/Fax

Practice location:
  • Phone: 786-269-3502
  • Fax:
Mailing address:
  • Phone: 786-712-5768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2835919
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: