=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730099557
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLUE DAWN ABA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2026
-----------------------------------------------------
Last Update Date | 09/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7935 PRESERVE CIR APT 411
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34119-6717
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-305-0527
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7935 PRESERVE CIR APT 411
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34119-6717
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-305-0527
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PATNER
-----------------------------------------------------
Name | ADRIAN CABALLERO OLIVARES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-925-8325
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------