Healthcare Provider Details

I. General information

NPI: 1720802556
Provider Name (Legal Business Name): NOVA ABA SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19009 NW 23RD ST
PEMBROKE PINES FL
33029-5329
US

IV. Provider business mailing address

2598 E SUNRISE BLVD UNIT 2104
FT LAUDERDALE FL
33304-3230
US

V. Phone/Fax

Practice location:
  • Phone: 786-567-2657
  • Fax: 954-425-9785
Mailing address:
  • Phone: 786-567-2657
  • 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 Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: WENDY PRADO
Title or Position: OWNER
Credential:
Phone: 786-567-2657