Organization Active NPI

Pediatric ABA 5 Inc

  • Community/Behavioral Health Agency
  • New PRT Rchy, FL
National Provider Identifier
1124516752
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
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
Last updated
Apr 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Wandy Caceres, ABABANPI 1194038992
Title
Ceo
Phone
(786) 597-2047

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 Directory

Locations

5623 US Highway 19
Ste 259
New Prt Rchy, FL 34652

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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.

Verify at the official NPI Registry.