Provider Demographics
NPI:1942791132
Name:PEDIATRIC ABA 6 INC
Entity Type:Organization
Organization Name:PEDIATRIC ABA 6 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CACERES
Authorized Official - Suffix:
Authorized Official - Credentials:ABAB
Authorized Official - Phone:786-597-2047
Mailing Address - Street 1:1010 E SILVER SPRINGS BLVD STE L
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-6763
Mailing Address - Country:US
Mailing Address - Phone:786-597-2047
Mailing Address - Fax:
Practice Address - Street 1:1010 E SILVER SPRINGS BLVD STE L
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6763
Practice Address - Country:US
Practice Address - Phone:786-597-2047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health