Healthcare Provider Details

I. General information

NPI: 1033909510
Provider Name (Legal Business Name): NELLA OBAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N MILITARY TRL STE 304
BOCA RATON FL
33431-6324
US

IV. Provider business mailing address

1241 NW 27TH AVE
POMPANO BEACH FL
33069-1852
US

V. Phone/Fax

Practice location:
  • Phone: 772-362-9878
  • Fax:
Mailing address:
  • Phone: 754-235-3366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: