Healthcare Provider Details

I. General information

NPI: 1326577149
Provider Name (Legal Business Name): EILY GARCIA AGUIAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2514 HOLLYWOOD BLVD STE 205
HOLLYWOOD FL
33020-6637
US

IV. Provider business mailing address

5414 W 27TH LN
HIALEAH FL
33016-4084
US

V. Phone/Fax

Practice location:
  • Phone: 754-400-7702
  • Fax:
Mailing address:
  • Phone: 305-505-6014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-19-9945
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-59765
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: