Healthcare Provider Details

I. General information

NPI: 1124841135
Provider Name (Legal Business Name): VALERIA A AGUILAR FERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4248 RANCH HOUSE RD
SAINT CLOUD FL
34772-6366
US

IV. Provider business mailing address

4248 RANCH HOUSE RD
SAINT CLOUD FL
34772-6366
US

V. Phone/Fax

Practice location:
  • Phone: 754-332-5923
  • Fax:
Mailing address:
  • Phone: 754-332-5923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-390545
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: