Healthcare Provider Details

I. General information

NPI: 1528954161
Provider Name (Legal Business Name): ANA YLY CID ARIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 WASHINGTON AVE FL 2
HOMESTEAD FL
33030-6012
US

IV. Provider business mailing address

7818 W 29TH LN APT 201
HIALEAH FL
33018-5175
US

V. Phone/Fax

Practice location:
  • Phone: 305-481-2198
  • Fax:
Mailing address:
  • Phone: 786-878-0705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-434512
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: