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NPI Code Detail

MEDICARE: DIVINO ABA SERVICES, LLC

MEDICARE: DIVINO ABA SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124510227
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIVINO ABA SERVICES, LLC
Provider Business Mailing Address
First Line : 9405 BARNSTEAD LN
Second Line :
City : PORT RICHEY
State : FL
Zip : 34668-4302
Country : US
Telephone Number : 727-967-2809
Fax Number :
Provider Business Practice Location Address
First Line : 9405 BARNSTEAD LN
Second Line :
City : PORT RICHEY
State : FL
Zip : 34668-4302
Country : US
Telephone Number : 727-967-2809
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : BARBARA DIVINO
Credential : BCBA
Telephone Number : 727-967-2809
Provider Enumeration Date : 06/04/2018
Last Update Date : 04/07/2025

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