Provider Demographics
NPI:1316494685
Name:AGUILA CUDEIRO, YUDY
Entity type:Individual
Prefix:
First Name:YUDY
Middle Name:
Last Name:AGUILA CUDEIRO
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 1:6721 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-1807
Mailing Address - Country:US
Mailing Address - Phone:786-805-8076
Mailing Address - Fax:
Practice Address - Street 1:6721 ALLEN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-1807
Practice Address - Country:US
Practice Address - Phone:786-805-8076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-05
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-51502103K00000X
FL0-19-9860106E00000X
171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No171W00000XOther Service ProvidersContractor