MEDICARE: ABA THERAPY OF PALM BEACH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033861455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABA THERAPY OF PALM BEACH LLC

Provider Business Mailing Address
First Line	:	1225 S MILITARY TRL STE E
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-4630
Country	:	US
Telephone Number	:	561-328-8312
Fax Number	:	561-584-5033

Provider Business Practice Location Address
First Line	:	1225 S MILITARY TRL STE E
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-4630
Country	:	US
Telephone Number	:	561-328-8312
Fax Number	:	561-584-5033

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SUSANA AUDI
Credential	:
Telephone Number	:	561-328-8312

Provider Enumeration Date	:	01/26/2022
Last Update Date	:	12/08/2025

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