Healthcare Provider Details

I. General information

NPI: 1215263223
Provider Name (Legal Business Name): KARLA D. AGUILU PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2009
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10716 GREEN HARVEST DR
RIVERVIEW FL
33578-6183
US

IV. Provider business mailing address

10716 GREEN HARVEST DR
RIVERVIEW FL
33578-6183
US

V. Phone/Fax

Practice location:
  • Phone: 727-509-7233
  • Fax:
Mailing address:
  • Phone: 727-509-7233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY8538
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY8538
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: