MEDICARE: ABOVE AND BEYOND ABA SERVICES 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
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1366276602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOVE AND BEYOND ABA SERVICES LLC

Provider Business Mailing Address
First Line	:	1729 SW 3RD AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-3412
Country	:	US
Telephone Number	:	239-784-5886
Fax Number	:

Provider Business Practice Location Address
First Line	:	1729 SW 3RD AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-3412
Country	:	US
Telephone Number	:	239-784-5886
Fax Number	:

Authorized Official
Title or Position	:	BOARD CERTIFIED BEHAVIOR ANALYST
Name	:	MR. JARON GRANT INATOME
Credential	:	BCBA
Telephone Number	:	239-784-5886

Provider Enumeration Date	:	08/29/2024
Last Update Date	:	02/14/2026

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