Healthcare Provider Details

I. General information

NPI: 1114867256
Provider Name (Legal Business Name): MIRIAM AGUILAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 SW 57TH AVE STE 313
WEST MIAMI FL
33144-5775
US

IV. Provider business mailing address

1350 SW 57TH AVE STE 313
WEST MIAMI FL
33144-5775
US

V. Phone/Fax

Practice location:
  • Phone: 786-404-1017
  • Fax: 786-216-7543
Mailing address:
  • Phone: 786-404-1017
  • Fax: 786-216-7543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-525066
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: