Healthcare Provider Details

I. General information

NPI: 1780489187
Provider Name (Legal Business Name): EMC SPEECH & ABA THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18350 NW 2ND AVE STE 500G
MIAMI GARDENS FL
33169-4569
US

IV. Provider business mailing address

8355 W FLAGLER ST STE 191
MIAMI FL
33144-2072
US

V. Phone/Fax

Practice location:
  • Phone: 786-907-1364
  • Fax:
Mailing address:
  • Phone: 786-501-9519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ELIAS JESUS MARTINEZ CABRERA
Title or Position: PRESIDENT
Credential:
Phone: 786-501-9519