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General NPI Number Information
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NPI Number | 1730714510
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Entity Type | Individual
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Provider Name | AILYN FRONTELA FERNANDEZ BCBA
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Gender | Female
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 18901 SW 106TH AVE STE A227
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City | CUTLER BAY
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State | FL
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Zip | 33157-7661
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Country | US
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Telephone | 786-732-7516
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Fax | 786-732-7718
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Provider Business Mailing Address
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Address Line | 13563 SW 255TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33032-6828
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Country | US
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Telephone | 786-603-7970
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-20-10885
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-50562
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License Number State | FL
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