Provider Demographics
NPI:1689493736
Name:AGUILUZ, ESTEFANI
Entity type:Individual
Prefix:
First Name:ESTEFANI
Middle Name:
Last Name:AGUILUZ
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 1:5875 SW 74TH TER # N38
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5266
Mailing Address - Country:US
Mailing Address - Phone:917-250-7950
Mailing Address - Fax:
Practice Address - Street 1:5875 SW 74TH TER # N38
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5266
Practice Address - Country:US
Practice Address - Phone:917-250-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
FLISW199111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical