Healthcare Provider Details

I. General information

NPI: 1790642460
Provider Name (Legal Business Name): ALIANA MENDOZA QUEROL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25791 S DIXIE HWY APT 1112
NARANJA FL
33032-5514
US

IV. Provider business mailing address

25791 S DIXIE HWY APT 1112
NARANJA FL
33032-5514
US

V. Phone/Fax

Practice location:
  • Phone: 786-771-5810
  • Fax:
Mailing address:
  • Phone: 786-771-5810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-465943
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: