MEDICARE: ABC BEHAVIOR HELP GROUP 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

General Provider Information

NPI Number	:	1558952036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC BEHAVIOR HELP GROUP LLC

Provider Business Mailing Address
First Line	:	4751 SW 132ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-5241
Country	:	US
Telephone Number	:	786-312-0429
Fax Number	:

Provider Business Practice Location Address
First Line	:	6361 PRESIDENTIAL CT # C109
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3543
Country	:	US
Telephone Number	:	786-312-0429
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ZULEMA YANISEIS SUAREZ SANCHEZ
Credential	:
Telephone Number	:	786-312-0429

Provider Enumeration Date	:	01/28/2021
Last Update Date	:	01/15/2025

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