Healthcare Provider Details

I. General information

NPI: 1346867801
Provider Name (Legal Business Name): ABC ALL BEHAVIOR THERAPIES, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 SW 152ND ST STE 106
PALMETTO BAY FL
33157-2066
US

IV. Provider business mailing address

8950 SW 152ND ST STE 106
PALMETTO BAY FL
33157-2066
US

V. Phone/Fax

Practice location:
  • Phone: 786-669-2619
  • Fax:
Mailing address:
  • Phone: 786-669-2619
  • 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 Code171W00000X
TaxonomyContractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: TANIA SOTO MANTILLA
Title or Position: PRESIDENT
Credential: BCBA
Phone: 786-669-2619