Healthcare Provider Details

I. General information

NPI: 1457038895
Provider Name (Legal Business Name): NEYDIS MERCEDES AGUIAR MARTINEZ RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 W FLAGLER ST STE 258C
MIAMI FL
33144-6002
US

IV. Provider business mailing address

3456 SW 113TH PL
MIAMI FL
33165-3414
US

V. Phone/Fax

Practice location:
  • Phone: 786-442-5503
  • Fax: 786-558-9279
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-87840
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: