MEDICARE: ORLYS BEHAVIORAL SUPPORT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1386586410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORLYS BEHAVIORAL SUPPORT LLC

Provider Business Mailing Address
First Line	:	12725 SW 204TH LN
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-5114
Country	:	US
Telephone Number	:	786-301-7976
Fax Number	:

Provider Business Practice Location Address
First Line	:	8630 NW 5TH TER APT 108
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-6810
Country	:	US
Telephone Number	:	786-602-8657
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AINA DENIS AGUILAR
Credential	:	BCBA
Telephone Number	:	786-301-7976

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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