Healthcare Provider Details

I. General information

NPI: 1700599099
Provider Name (Legal Business Name): INFINITY ABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2023
Last Update Date: 01/02/2023
Certification Date: 01/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

467 ALADDIN RD
SPRING HILL FL
34609-6402
US

IV. Provider business mailing address

467 ALADDIN RD
SPRING HILL FL
34609-6402
US

V. Phone/Fax

Practice location:
  • Phone: 813-748-7571
  • Fax:
Mailing address:
  • Phone: 813-748-7571
  • 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: MR. JOEL HERNANDEZ JR.
Title or Position: OWNER
Credential: BCBA
Phone: 813-748-7571