Healthcare Provider Details

I. General information

NPI: 1376046417
Provider Name (Legal Business Name): VIOLETA ALDECOA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2018
Last Update Date: 03/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S ROYAL POINCIANA BLVD STE 300
MIAMI SPRINGS FL
33166-6667
US

IV. Provider business mailing address

700 S ROYAL POINCIANA BLVD STE 300
MIAMI SPRINGS FL
33166-6667
US

V. Phone/Fax

Practice location:
  • Phone: 305-668-9000
  • Fax: 305-662-1788
Mailing address:
  • Phone: 305-668-9000
  • Fax: 305-662-1788

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: