Healthcare Provider Details

I. General information

NPI: 1518583863
Provider Name (Legal Business Name): AITANA CONTRERAS RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8998 NW 116TH ST
HIALEAH GARDENS FL
33018-4105
US

IV. Provider business mailing address

8998 NW 116TH ST
HIALEAH GARDENS FL
33018-4105
US

V. Phone/Fax

Practice location:
  • Phone: 786-261-1590
  • Fax:
Mailing address:
  • Phone: 786-261-1590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-26-17217
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: