Healthcare Provider Details

I. General information

NPI: 1588287692
Provider Name (Legal Business Name): AILIN MILIAN GUILARTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2020
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 SOUTHFORK DR
KINDRED FL
34744-5773
US

IV. Provider business mailing address

1623 SOUTHFORK DR
KINDRED FL
34744-5773
US

V. Phone/Fax

Practice location:
  • Phone: 407-984-8916
  • Fax:
Mailing address:
  • Phone: 407-984-8916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-117619
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: