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General NPI Number Information
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NPI Number | 1912537036
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Entity Type | Organization
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Legal Business Name | INFINITE MINDS ABA LLC
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Dates
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Enumeration Date | 01/16/2020
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 1191 E NEWPORT CENTER DR STE 103
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-7736
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Country | US
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Telephone | 954-644-0682
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Fax | 754-333-4768
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Provider Business Mailing Address
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Address Line | 1191 E NEWPORT CENTER DR STE 103
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-7736
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Country | US
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Telephone | 954-644-0682
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Fax | 754-333-4768
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Authorized Official
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Title or Position | PARTNER
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Name | ANDRE DE PAIVA COELHO SOPHIA
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Credential |
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Telephone | 954-644-0682
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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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