Provider Demographics
NPI:1013295476
Name:AGUIRRE, KALEY BROOKE (BS)
Entity Type:Individual
Prefix:MRS
First Name:KALEY
Middle Name:BROOKE
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:KALEY
Other - Middle Name:BROOKE
Other - Last Name:KOKINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:6500 LAKE GRAY BLVD
Mailing Address - Street 2:APT 1319
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-7538
Mailing Address - Country:US
Mailing Address - Phone:805-279-3534
Mailing Address - Fax:
Practice Address - Street 1:2708 NE 14TH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-3565
Practice Address - Country:US
Practice Address - Phone:888-880-9270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist