Healthcare Provider Details

I. General information

NPI: 1699688127
Provider Name (Legal Business Name): AYLEN URRA PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14289 SW 94TH CIRCLE LN APT 101
MIAMI FL
33186-1134
US

IV. Provider business mailing address

14289 SW 94TH CIRCLE LN APT 101
MIAMI FL
33186-1134
US

V. Phone/Fax

Practice location:
  • Phone: 305-510-5925
  • Fax:
Mailing address:
  • Phone: 305-510-5925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA32823
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: