Provider Demographics
NPI:1093459422
Name:AGUILAR, KIMBERLY DANIELA (COTA/L)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:DANIELA
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 NW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-6623
Mailing Address - Country:US
Mailing Address - Phone:305-599-3021
Mailing Address - Fax:
Practice Address - Street 1:1501 NW 29TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-6623
Practice Address - Country:US
Practice Address - Phone:305-599-3021
Practice Address - Fax:305-599-3033
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA16835224Z00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant