Provider Demographics
NPI:1548057474
Name:AGUILAR MILANES, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:AGUILAR MILANES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 VICTORIA PARK RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-5614
Mailing Address - Country:US
Mailing Address - Phone:954-612-2910
Mailing Address - Fax:
Practice Address - Street 1:3210 VICTORIA PARK RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-5614
Practice Address - Country:US
Practice Address - Phone:954-612-2910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-425819106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician