Provider Demographics
NPI:1851012306
Name:AGUILAR MUNOZ, ANA LUCIA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:LUCIA
Last Name:AGUILAR MUNOZ
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 1:1617 SW 19TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-3131
Mailing Address - Country:US
Mailing Address - Phone:239-814-3751
Mailing Address - Fax:
Practice Address - Street 1:9857 COLONIAL WALK N
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-6307
Practice Address - Country:US
Practice Address - Phone:239-814-3751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician