Provider Demographics
NPI:1730532110
Name:GARCIA MORALES, AYLEN (BCBA)
Entity type:Individual
Prefix:
First Name:AYLEN
Middle Name:
Last Name:GARCIA MORALES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1182 NW 134TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-2279
Mailing Address - Country:US
Mailing Address - Phone:786-763-5493
Mailing Address - Fax:
Practice Address - Street 1:1182 NW 134TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33182-2279
Practice Address - Country:US
Practice Address - Phone:786-763-5493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBCBA-1-20-42152103K00000X
FLSZ11392235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019277600Medicaid