MEDICARE: NUNEZ ABA THERAPY 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1811608839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUNEZ ABA THERAPY LLC

Provider Business Mailing Address
First Line	:	15524 SW 25TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-5770
Country	:	US
Telephone Number	:	786-530-5777
Fax Number	:

Provider Business Practice Location Address
First Line	:	15524 SW 25TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-5770
Country	:	US
Telephone Number	:	786-530-5777
Fax Number	:

Authorized Official
Title or Position	:	LEAD BOARD CERTIFIED BEHAVIOR ANALY
Name	:	CHANEL EMILY E NUNEZ
Credential	:	BCBA
Telephone Number	:	786-530-5777

Provider Enumeration Date	:	12/09/2022
Last Update Date	:	12/09/2022

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