Healthcare Provider Details

I. General information

NPI: 1134097256
Provider Name (Legal Business Name): MISS ADRIANA A URBINA JUAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9445 FONTAINEBLEAU BLVD
MIAMI FL
33172-7519
US

IV. Provider business mailing address

9445 FONTAINEBLEAU BLVD APT 201
MIAMI FL
33172-5545
US

V. Phone/Fax

Practice location:
  • Phone: 786-209-7076
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-460823
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: