Healthcare Provider Details

I. General information

NPI: 1093646499
Provider Name (Legal Business Name): ELEVATE ABA THERAPY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10911 SW 156TH ST
MIAMI FL
33157-1283
US

IV. Provider business mailing address

10911 SW 156TH ST
MIAMI FL
33157-1283
US

V. Phone/Fax

Practice location:
  • Phone: 786-962-3378
  • Fax:
Mailing address:
  • Phone: 786-962-3378
  • 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: GEIDY AGUILERA
Title or Position: PRESIDENT
Credential:
Phone: 786-962-3378