Provider Demographics
NPI:1619473642
Name:ABA R' US, LLC
Entity Type:Organization
Organization Name:ABA R' US, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:IDENIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:786-502-3486
Mailing Address - Street 1:14100 PALMETTO FRNTG RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1568
Mailing Address - Country:US
Mailing Address - Phone:786-502-3486
Mailing Address - Fax:
Practice Address - Street 1:14100 PALMETTO FRNTG RD STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1568
Practice Address - Country:US
Practice Address - Phone:786-502-3486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1376967950Medicaid