Provider Demographics
NPI:1376927988
Name:AQUINO, SAYIRA IVONNE
Entity Type:Individual
Prefix:
First Name:SAYIRA
Middle Name:IVONNE
Last Name:AQUINO
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:SAYIRA
Other - Middle Name:IVONNE
Other - Last Name:AQUINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:14340 SW 260TH ST # ST115
Mailing Address - Street 2:
Mailing Address - City:NARANJA
Mailing Address - State:FL
Mailing Address - Zip Code:33032-6611
Mailing Address - Country:US
Mailing Address - Phone:305-458-4728
Mailing Address - Fax:
Practice Address - Street 1:9299 SW 152ND ST STE 200
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1776
Practice Address - Country:US
Practice Address - Phone:305-458-4728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMHI-6054101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health