MEDICARE: LOURDES CRISTINA AGUILAR BCBA

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	:	1972896603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOURDES CRISTINA AGUILAR BCBA

Provider Business Mailing Address
First Line	:	5961 SW 68TH ST APT 714
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-3557
Country	:	US
Telephone Number	:	786-269-9254
Fax Number	:

Provider Business Practice Location Address
First Line	:	5961 SW 68TH ST APT 714
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-3557
Country	:	US
Telephone Number	:	786-269-9254
Fax Number	:

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

Provider Enumeration Date	:	05/27/2011
Last Update Date	:	06/12/2025

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