MEDICARE: ABS THERAPY GROUP INC

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

General Provider Information

NPI Number	:	1164203733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABS THERAPY GROUP INC

Provider Business Mailing Address
First Line	:	633 NE 167TH ST STE 802
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-2446
Country	:	US
Telephone Number	:	305-244-0128
Fax Number	:

Provider Business Practice Location Address
First Line	:	633 NE 167TH ST STE 802
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-2446
Country	:	US
Telephone Number	:	305-244-0128
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SADY SOTO LAMAS
Credential	:
Telephone Number	:	305-244-0128

Provider Enumeration Date	:	10/10/2023
Last Update Date	:	10/10/2023

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