Healthcare Provider Details

I. General information

NPI: 1598575706
Provider Name (Legal Business Name): AILYS MEJIAS GARCIA RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3309 W WATERS AVE STE A
TAMPA FL
33614-2766
US

IV. Provider business mailing address

3309 W WATERS AVE STE A
TAMPA FL
33614-2766
US

V. Phone/Fax

Practice location:
  • Phone: 813-898-0014
  • Fax: 813-898-0015
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number24-401251
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: