Provider Demographics
NPI:1477399566
Name:EMPOWER BEHAVIOR ABA THERAPY LLC
Entity type:Organization
Organization Name:EMPOWER BEHAVIOR ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN ALFONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-920-9137
Mailing Address - Street 1:11890 SW 8TH ST STE 506
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1701
Mailing Address - Country:US
Mailing Address - Phone:786-920-9137
Mailing Address - Fax:786-957-2891
Practice Address - Street 1:11890 SW 8TH ST STE 506
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1701
Practice Address - Country:US
Practice Address - Phone:786-920-9137
Practice Address - Fax:786-957-2891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty