Provider Demographics
NPI:1841785409
Name:GOYTISOLO, AYLIN DE LA CARIDAD
Entity Type:Individual
Prefix:
First Name:AYLIN
Middle Name:DE LA CARIDAD
Last Name:GOYTISOLO
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 1:10235 SW 24TH ST APT C153
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2509
Mailing Address - Country:US
Mailing Address - Phone:786-327-8650
Mailing Address - Fax:
Practice Address - Street 1:10235 SW 24TH ST APT C153
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2509
Practice Address - Country:US
Practice Address - Phone:786-327-8650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician