Healthcare Provider Details
I. General information
NPI: 1386586410
Provider Name (Legal Business Name): ORLYS BEHAVIORAL SUPPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8630 NW 5TH TER APT 108
MIAMI FL
33126-6810
US
IV. Provider business mailing address
12725 SW 204TH LN
MIAMI FL
33177-5114
US
V. Phone/Fax
- Phone: 786-602-8657
- Fax:
- Phone: 786-301-7976
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AINA
DENIS AGUILAR
Title or Position: OWNER
Credential: BCBA
Phone: 786-301-7976