MEDICARE: INDEPENDENT PATHWAYS ABA 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	:	1649129404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDEPENDENT PATHWAYS ABA LLC

Provider Business Mailing Address
First Line	:	305 S 57TH WAY
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33023-1433
Country	:	US
Telephone Number	:	305-979-2519
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 S 57TH WAY
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33023-1433
Country	:	US
Telephone Number	:	305-979-2519
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. ENOCK ALOUIDOR
Credential	:
Telephone Number	:	305-979-2519

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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