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NPI Code Detail

MEDICARE: 123 ABA SERVICES, LLC

MEDICARE: 123 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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1639024086
Entity Type Code : Organization
Provider Name (Legal Business Name) : 123 ABA SERVICES, LLC
Provider Business Mailing Address
First Line : 9126 FOX SPARROW RD
Second Line :
City : TAMPA
State : FL
Zip : 33626-2653
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4026 HENDERSON BLVD STE B
Second Line :
City : TAMPA
State : FL
Zip : 33629-4940
Country : US
Telephone Number : 727-481-9091
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SANDY CZARNECKI
Credential :
Telephone Number : 727-481-9091
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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Directions to “123 ABA SERVICES, LLC ” Practice Location

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