=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295691384
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABA LED BY ME AUTISM SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/01/2026
-----------------------------------------------------
Last Update Date | 01/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4280 GALT OCEAN DR
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33308-6147
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-489-8114
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4280 GALT OCEAN DR APT 2K
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33308-6118
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-489-8114
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BCBA
-----------------------------------------------------
Name | ALEXANDRA J SANTA MARIA
-----------------------------------------------------
Credential | BCBA
-----------------------------------------------------
Telephone | 801-502-4212
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------