Provider Demographics
NPI:1831448141
Name:ABA OF MIAMI, INC
Entity type:Organization
Organization Name:ABA OF MIAMI, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PH.D
Authorized Official - Prefix:
Authorized Official - First Name:SOLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:YOHANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA-DOCTORAL
Authorized Official - Phone:786-419-5998
Mailing Address - Street 1:9884 NW 135TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1600
Mailing Address - Country:US
Mailing Address - Phone:786-419-5998
Mailing Address - Fax:
Practice Address - Street 1:2100 W 76TH ST STE 306
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5500
Practice Address - Country:US
Practice Address - Phone:305-549-8770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-31
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-10-6902103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL06679600Medicaid