Provider Demographics
NPI:1972049211
Name:BEYTIA AGUILAR, ROSSANA (BCABA)
Entity Type:Individual
Prefix:MISS
First Name:ROSSANA
Middle Name:
Last Name:BEYTIA AGUILAR
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13310 ARENA PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-1801
Mailing Address - Country:US
Mailing Address - Phone:813-764-3448
Mailing Address - Fax:
Practice Address - Street 1:4302 GUNN HWY APT 905
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-8771
Practice Address - Country:US
Practice Address - Phone:813-764-3448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0167484106E00000X
FL1-20-41961103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst