Provider Demographics
NPI:1922648161
Name:AQUARO, SIMONA
Entity Type:Individual
Prefix:
First Name:SIMONA
Middle Name:
Last Name:AQUARO
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 1:7950 NE BAYSHORE CT # W1002
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-6398
Mailing Address - Country:US
Mailing Address - Phone:786-812-8976
Mailing Address - Fax:
Practice Address - Street 1:10440 SW 156TH CT APT 719
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-3533
Practice Address - Country:US
Practice Address - Phone:786-812-8976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-15
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-22-63042103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst