Provider Demographics
NPI:1033566047
Name:LLANO GONZALEZ, AYLIN (BCBA)
Entity type:Individual
Prefix:
First Name:AYLIN
Middle Name:
Last Name:LLANO GONZALEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14109 SW 155TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-0946
Mailing Address - Country:US
Mailing Address - Phone:786-641-4277
Mailing Address - Fax:
Practice Address - Street 1:14109 SW 155TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-0946
Practice Address - Country:US
Practice Address - Phone:786-641-4277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BCABA-0-17-7661106E00000X
FLBCBA-1-19-34746103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
BCABA-0-17-7661OtherBEHAVIOR ANALYST CERTIFICATION BOARD
FL017489900Medicaid