MEDICARE: ABA MAX CORP

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	:	1922859743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABA MAX CORP

Provider Business Mailing Address
First Line	:	6301 NW 5TH WAY
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-6131
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 NW 5TH WAY
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-6131
Country	:	US
Telephone Number	:	786-597-3928
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARIA NORONA
Credential	:	PA
Telephone Number	:	786-597-3928

Provider Enumeration Date	:	03/29/2024
Last Update Date	:	03/29/2024

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