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General NPI Number Information
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NPI Number | 1568161487
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Entity Type | Organization
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Legal Business Name | BLUE HORIZON ABA LLC
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 8950 SW 152ND ST STE 112
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City | PALMETTO BAY
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State | FL
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Zip | 33157-2066
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Country | US
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Telephone | 786-432-0829
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Fax | 786-513-3333
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Provider Business Mailing Address
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Address Line | 8950 SW 152ND ST STE 112
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City | PALMETTO BAY
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State | FL
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Zip | 33157-2066
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Country | US
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Telephone | 786-432-0829
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Fax | 786-513-3333
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Authorized Official
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Title or Position | PRESIDENT
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Name | GABRIEL LOPEZ
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Credential |
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Telephone | 786-678-5060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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