Provider Demographics
NPI:1063027126
Name:BLUE PENINSULA ABA INC
Entity Type:Organization
Organization Name:BLUE PENINSULA ABA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:NARANJO CALA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, BCBA
Authorized Official - Phone:786-803-1498
Mailing Address - Street 1:505 RUNNING HORSE RD
Mailing Address - Street 2:
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33584-4139
Mailing Address - Country:US
Mailing Address - Phone:813-654-8707
Mailing Address - Fax:
Practice Address - Street 1:4730 N HABANA AVE STE 303
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7187
Practice Address - Country:US
Practice Address - Phone:813-654-8707
Practice Address - Fax:813-640-2153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty