Active NPI
Pediatric ABA 5 Inc
- Community/Behavioral Health Agency
- New PRT Rchy, FL
National Provider Identifier
1124516752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- PEDIATRIC ABA 5 INC
- Practice address
- 5623 US Highway 19 Ste 259
New PRT Rchy, FL 34652-3752 - Phone
- (786) 597-2047
- NPI assigned
- Apr 30, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Wandy Caceres, ABABA
- Title
- Ceo
- Phone
- (786) 597-2047
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
5623 US Highway 19 Ste 259
New PRT Rchy, FL 34652-3752
Mailing address
5623 US Highway 19 Ste 259
New PRT Rchy, FL 34652-3752
Phone (786) 597-2047
National Provider Directory
National Provider DirectoryLocations
5623 US Highway 19
Ste 259
New Prt Rchy, FL 34652
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525046400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1525046400000",
"number": "1124516752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5623 US HIGHWAY 19 STE 259",
"city": "NEW PRT RCHY",
"state": "FL",
"postal_code": "346523752",
"telephone_number": "786-597-2047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5623 US HIGHWAY 19 STE 259",
"city": "NEW PRT RCHY",
"state": "FL",
"postal_code": "346523752",
"telephone_number": "786-597-2047"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEDIATRIC ABA 5 INC",
"organizational_subpart": "NO",
"enumeration_date": "2018-04-30",
"last_updated": "2018-04-30",
"status": "A",
"authorized_official_last_name": "CACERES",
"authorized_official_first_name": "WANDY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "786-597-2047",
"authorized_official_credential": "ABABA"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New PRT Rchy, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.