Healthcare Provider Details

I. General information

NPI: 1730532110
Provider Name (Legal Business Name): AYLEN GARCIA MORALES BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1182 NW 134TH PL
MIAMI FL
33182-2279
US

IV. Provider business mailing address

1182 NW 134TH PL
MIAMI FL
33182-2279
US

V. Phone/Fax

Practice location:
  • Phone: 786-763-5493
  • Fax:
Mailing address:
  • Phone: 786-763-5493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ11392
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA-1-20-42152
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: