Healthcare Provider Details

I. General information

NPI: 1841124096
Provider Name (Legal Business Name): AARON BRYCE LOUIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10661 NW 17TH CT
PLANTATION FL
33322-6469
US

IV. Provider business mailing address

10661 NW 17TH CT
PLANTATION FL
33322-6469
US

V. Phone/Fax

Practice location:
  • Phone: 954-531-5776
  • Fax:
Mailing address:
  • Phone: 954-531-5776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-538560
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: