Provider Demographics
NPI:1760260673
Name:ABA SPECIALIST OF FLORIDA LLC
Entity Type:Organization
Organization Name:ABA SPECIALIST OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:RODRIGUEZ IBARRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-970-8863
Mailing Address - Street 1:1500 WESTON RD STE 200-11
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3263
Mailing Address - Country:US
Mailing Address - Phone:786-970-8863
Mailing Address - Fax:
Practice Address - Street 1:1500 WESTON RD STE 200-11
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3263
Practice Address - Country:US
Practice Address - Phone:786-970-8863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty