Provider Demographics
NPI:1649037466
Name:ABELLA, AYSA
Entity type:Individual
Prefix:
First Name:AYSA
Middle Name:
Last Name:ABELLA
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 1:8251 SW 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5227
Mailing Address - Country:US
Mailing Address - Phone:786-458-9919
Mailing Address - Fax:
Practice Address - Street 1:2550 NW 72ND AVE STE 311
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33122-1348
Practice Address - Country:US
Practice Address - Phone:305-209-4547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician