MEDICARE: ATLAS ABA

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1730973504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLAS ABA

Provider Business Mailing Address
First Line	:	1621 ESPANOLA AVE
Second Line	:
City	:	HOLLY HILL
State	:	FL
Zip	:	32117-1745
Country	:	US
Telephone Number	:	386-517-4614
Fax Number	:	833-907-5900

Provider Business Practice Location Address
First Line	:	1621 ESPANOLA AVE
Second Line	:
City	:	HOLLY HILL
State	:	FL
Zip	:	32117-1745
Country	:	US
Telephone Number	:	386-872-3012
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	TAMEEKA BROWN
Credential	:
Telephone Number	:	386-517-4614

Provider Enumeration Date	:	04/07/2025
Last Update Date	:	03/15/2026

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Directions to “ATLAS ABA ” Practice Location

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