Provider Demographics
NPI:1225740434
Name:ABA FLORIDA ACADEMY LLC
Entity Type:Organization
Organization Name:ABA FLORIDA ACADEMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:P
Authorized Official - Last Name:BAVARESCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-280-0937
Mailing Address - Street 1:3414 W 84TH ST STE D110
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4932
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3414 W 84TH ST STE D110
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-4932
Practice Address - Country:US
Practice Address - Phone:786-280-0937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty