Healthcare Provider Details

I. General information

NPI: 1437745221
Provider Name (Legal Business Name): ILEANA BAUZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2020
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16011 SW 87TH TER
MIAMI FL
33193-5298
US

IV. Provider business mailing address

16011 SW 87TH TER
MIAMI FL
33193-5298
US

V. Phone/Fax

Practice location:
  • Phone: 786-830-5118
  • Fax:
Mailing address:
  • Phone: 786-830-5118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: