MEDICARE: AMARILIS AGUILERA

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	106S00000X	Behavior Technician		TX
2	247200000X	Other Technician		TX
3	208D00000X	General Practice Physician	ACN1741	FL

General Provider Information

NPI Number	:	1497362842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMARILIS AGUILERA

Provider Business Mailing Address
First Line	:	1709 W 13TH ST UNIT B
Second Line	:
City	:	ODESSA
State	:	TX
Zip	:	79763-3367
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 1ST ST S
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-3255
Country	:	US
Telephone Number	:	863-877-0064
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2020
Last Update Date	:	08/06/2025

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Directions to “ AMARILIS AGUILERA ” Practice Location

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