Healthcare Provider Details

I. General information

NPI: 1457046021
Provider Name (Legal Business Name): LIUNIOR AGUILA CUDEIRO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8240 SW 149TH CT APT 203
MIAMI FL
33193-3102
US

IV. Provider business mailing address

8240 SW 149TH CT APT 203
MIAMI FL
33193-3102
US

V. Phone/Fax

Practice location:
  • Phone: 786-426-8103
  • Fax:
Mailing address:
  • Phone: 786-426-8103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-308256
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: