Healthcare Provider Details

I. General information

NPI: 1720911506
Provider Name (Legal Business Name): MALVYS GUERRA ALOMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7759 NW 162ND TER
MIAMI LAKES FL
33016-6159
US

IV. Provider business mailing address

7759 NW 162ND TER
MIAMI LAKES FL
33016-6159
US

V. Phone/Fax

Practice location:
  • Phone: 786-246-6519
  • Fax: 786-246-6519
Mailing address:
  • Phone: 786-246-6519
  • Fax: 786-246-6519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number26-542369
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: