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NPI Code Detail

MEDICARE: DERSA ABA LLC

MEDICARE: DERSA ABA 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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1649089046
Entity Type Code : Organization
Provider Name (Legal Business Name) : DERSA ABA LLC
Provider Business Mailing Address
First Line : 2896 VIA VELLARIA
Second Line :
City : LAKE WORTH
State : FL
Zip : 33461-1749
Country : US
Telephone Number : 561-460-2811
Fax Number :
Provider Business Practice Location Address
First Line : 2896 VIA VELLARIA
Second Line :
City : LAKE WORTH
State : FL
Zip : 33461-1749
Country : US
Telephone Number : 561-460-2811
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : ALEXANDER SANCHEZ
Credential : BCBA
Telephone Number : 561-345-8766
Provider Enumeration Date : 12/31/2024
Last Update Date : 12/31/2024

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Directions to “DERSA ABA LLC ” Practice Location

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