Provider Demographics
NPI:1720643109
Name:SMART BA INC
Entity Type:Organization
Organization Name:SMART BA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FIDEL
Authorized Official - Middle Name:ALEJANDRO
Authorized Official - Last Name:BATISTA VILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-459-4581
Mailing Address - Street 1:1561 KUDZA RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-5520
Mailing Address - Country:US
Mailing Address - Phone:305-549-4581
Mailing Address - Fax:
Practice Address - Street 1:1561 KUDZA RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-5520
Practice Address - Country:US
Practice Address - Phone:305-549-4581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-01
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty