Healthcare Provider Details

I. General information

NPI: 1184336760
Provider Name (Legal Business Name): AILEN FLEITES ORDENANA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2022
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8390 NW 103RD ST APT 203H
HIALEAH GARDENS FL
33016-4659
US

IV. Provider business mailing address

8390 NW 103RD ST APT 203H
HIALEAH GARDENS FL
33016-4659
US

V. Phone/Fax

Practice location:
  • Phone: 786-294-7510
  • Fax:
Mailing address:
  • Phone: 786-294-7510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88474
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: