Provider Demographics
NPI:1669713004
Name:AGUILAR PEREZ, MAYELIN (MD)
Entity type:Individual
Prefix:
First Name:MAYELIN
Middle Name:
Last Name:AGUILAR PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11044 DAWNVIEW LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-7421
Mailing Address - Country:US
Mailing Address - Phone:407-305-1778
Mailing Address - Fax:
Practice Address - Street 1:11044 DAWNVIEW LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-7421
Practice Address - Country:US
Practice Address - Phone:407-486-0168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 252Y00000X
FLMH24229101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No252Y00000XAgenciesEarly Intervention Provider Agency