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General NPI Number Information
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NPI Number | 1376927988
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Entity Type | Individual
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Provider Name | SAYIRA IVONNE AQUINO
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Gender | Female
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 9299 SW 152ND ST STE 200
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1776
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Country | US
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Telephone | 305-458-4728
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Fax |
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Provider Business Mailing Address
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Address Line | 14340 SW 260TH ST # ST115
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City | NARANJA
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State | FL
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Zip | 33032-6611
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Country | US
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Telephone | 305-458-4728
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHI-6054
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License Number State | FL
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