Healthcare Provider Details

I. General information

NPI: 1659611580
Provider Name (Legal Business Name): ABC BEHAVIOR DEVELOPMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 03/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12101 SW 82ND AVE
PINECREST FL
33156-5220
US

IV. Provider business mailing address

12101 SW 82ND AVE
PINECREST FL
33156-5220
US

V. Phone/Fax

Practice location:
  • Phone: 786-262-1840
  • Fax:
Mailing address:
  • Phone: 786-262-1840
  • 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: FIORELLA SCAGLIA
Title or Position: PRESIDENT
Credential: BCBA
Phone: 786-262-1840