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General NPI Number Information
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NPI Number | 1467313460
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Entity Type | Organization
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Legal Business Name | ABA WINGS INC
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 5647 SYCAMORE CANYON DR
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City | KISSIMMEE
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State | FL
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Zip | 34758-1727
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Country | US
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Telephone | 646-966-2583
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Fax |
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Provider Business Mailing Address
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Address Line | 5647 SYCAMORE CANYON DR
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City | KISSIMMEE
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State | FL
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Zip | 34758-1727
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Country | US
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Telephone | 646-966-2583
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MARIELYS MARTINEZ IZQUIERDO
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Credential | BCABA, SLP
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Telephone | 646-966-2583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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