Healthcare Provider Details

I. General information

NPI: 1861912982
Provider Name (Legal Business Name): SADYS MEJIA AGUIRRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17660 SW 254TH ST
HOMESTEAD FL
33031-1903
US

IV. Provider business mailing address

17660 SW 254TH ST
HOMESTEAD FL
33031-1903
US

V. Phone/Fax

Practice location:
  • Phone: 786-339-0886
  • Fax:
Mailing address:
  • Phone: 786-339-0886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: