Provider Demographics
NPI:1639851165
Name:GIFTED IN GREATNESS ABA & AUTISM CENTER
Entity Type:Organization
Organization Name:GIFTED IN GREATNESS ABA & AUTISM CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:DIDIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA OSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-702-0435
Mailing Address - Street 1:1970 SE 22ND CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-1238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:92295 OLD STATE RD
Practice Address - Street 2:
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-3307
Practice Address - Country:US
Practice Address - Phone:786-975-4609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty