Provider Demographics
NPI:1366210940
Name:BURNS, AISHA
Entity type:Individual
Prefix:
First Name:AISHA
Middle Name:
Last Name:BURNS
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 1:7904 SAIL CLOVER LN STE 200
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33540-2413
Mailing Address - Country:US
Mailing Address - Phone:352-433-9084
Mailing Address - Fax:
Practice Address - Street 1:633 NE 167TH ST STE 829
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-2442
Practice Address - Country:US
Practice Address - Phone:305-930-5648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician