Provider Demographics
NPI:1366136855
Name:ARIAS VILTRES, ILEANA
Entity type:Individual
Prefix:
First Name:ILEANA
Middle Name:
Last Name:ARIAS VILTRES
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 1:8475 SW 185TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7245
Mailing Address - Country:US
Mailing Address - Phone:786-519-5135
Mailing Address - Fax:
Practice Address - Street 1:8475 SW 185TH TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7245
Practice Address - Country:US
Practice Address - Phone:786-519-5135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-23-274547106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician