Pediatric Aba 5 INC
Community/Behavioral Health in New Prt Rchy, FL. Organization (NPI-2).
NPI number1124516752
StatusActive
Last updated in NPPESApr 30, 2018
Details
- NPI
- 1124516752
- Entity type
- Organization (NPI-2)
- Legal business name
- Pediatric Aba 5 INC
- Organization subpart
- No
- Enumeration date
- Apr 30, 2018
- Last updated
- Apr 30, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
5623 Us Highway 19 Ste 259New Prt Rchy, FL 34652-3752
Phone 786-597-2047
Mailing address
5623 Us Highway 19 Ste 259New Prt Rchy, FL 34652-3752
Phone 786-597-2047
Authorized official
Wandy Caceres
Ceo
7865972047
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