Healthcare Provider Details

I. General information

NPI: 1912411422
Provider Name (Legal Business Name): ABA ALLIANCE CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2017
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9560 SW 107TH AVE STE 106A
MIAMI FL
33176-2790
US

IV. Provider business mailing address

9560 SW 107TH AVE STE 106A
MIAMI FL
33176-2790
US

V. Phone/Fax

Practice location:
  • Phone: 786-899-0308
  • Fax: 786-899-0598
Mailing address:
  • Phone: 786-899-0308
  • Fax: 786-899-0598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: YANELKYS MARTINEZ
Title or Position: CEO
Credential: OWNER
Phone: 786-899-0308