Healthcare Provider Details

I. General information

NPI: 1073264461
Provider Name (Legal Business Name): 3D ABA THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2022
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14098 SW 17TH TER
MIAMI FL
33175-7056
US

IV. Provider business mailing address

14098 SW 17TH TER
MIAMI FL
33175-7056
US

V. Phone/Fax

Practice location:
  • Phone: 786-426-1717
  • Fax:
Mailing address:
  • Phone: 786-426-1717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: LOREYLE CONTRERAS
Title or Position: CEO
Credential:
Phone: 786-426-1717