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General NPI Number Information
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NPI Number | 1336504828
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Entity Type | Organization
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Legal Business Name | MAGALIS AGUILERA, PSY.D., P.A
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Dates
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Enumeration Date | 12/28/2015
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Last Update Date | 12/28/2015
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Provider Practice Location Address
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Address Line | 9240 SW 72ND ST SUITE 106
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City | MIAMI
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State | FL
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Zip | 33173-3261
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Country | US
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Telephone | 305-595-8787
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Fax | 305-595-6087
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Provider Business Mailing Address
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Address Line | 9240 SW 72ND ST SUITE 106
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City | MIAMI
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State | FL
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Zip | 33173-3261
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Country | US
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Telephone | 305-595-8787
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Fax | 305-595-6087
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAGALIS AGUILERA
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Credential | PSY.D
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Telephone | 305-595-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | PY6494
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License Number State | FL
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