Healthcare Provider Details

I. General information

NPI: 1598571416
Provider Name (Legal Business Name): ELIANA AMAR ABA SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 NW 126TH AVE APT 317
SUNRISE FL
33323-6322
US

IV. Provider business mailing address

2925 NW 126TH AVE APT 317
SUNRISE FL
33323-6322
US

V. Phone/Fax

Practice location:
  • Phone: 954-410-3934
  • Fax:
Mailing address:
  • Phone: 954-410-3934
  • 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 Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIANA AMAR
Title or Position: CLINICAL DIRECTOR
Credential: BCBA
Phone: 954-410-3934