Healthcare Provider Details

I. General information

NPI: 1013466515
Provider Name (Legal Business Name): AILEN O MUSTELIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2016
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7108 S KANNER HWY
STUART FL
34997-7462
US

IV. Provider business mailing address

2090 W PRESERVE WAY APT 202
MIRAMAR FL
33025-3909
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone: 786-518-7031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-15-05442
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: