MEDICARE: INFINITE ABA THERAPY SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	106E00000X	Assistant Behavior Analyst
2	106S00000X	Behavior Technician
3	251S00000X	Community/Behavioral Health Agency
4	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1972384717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITE ABA THERAPY SERVICES, INC

Provider Business Mailing Address
First Line	:	13030 TAMPA OAKS BLVD UNIT 3415
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-1948
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13030 TAMPA OAKS BLVD UNIT 3415
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-1948
Country	:	US
Telephone Number	:	305-200-7002
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	QIANA BAKER
Credential	:
Telephone Number	:	305-200-7002

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	10/09/2023

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