=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730868134
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | READY TO TEACH ABA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2023
-----------------------------------------------------
Last Update Date | 10/21/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 833 SW 5TH ST
-----------------------------------------------------
City | FLORIDA CITY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33034-4600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-240-7368
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 833 SW 5TH ST
-----------------------------------------------------
City | FLORIDA CITY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33034-4600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-240-7368
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | NELSAELENA SUAREZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-240-7368
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------