Provider Demographics
NPI:1184336760
Name:FLEITES ORDENANA, AILEN
Entity type:Individual
Prefix:
First Name:AILEN
Middle Name:
Last Name:FLEITES ORDENANA
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 1:8390 NW 103RD ST APT 203H
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33016-4659
Mailing Address - Country:US
Mailing Address - Phone:786-294-7510
Mailing Address - Fax:
Practice Address - Street 1:8390 NW 103RD ST APT 203H
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-4659
Practice Address - Country:US
Practice Address - Phone:786-294-7510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-15
Last Update Date:2024-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-24-15038106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst