Organization Active NPI

ABA Rehabilitation Center, Inc

Doing business as ABA Med Group

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1770051047
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ABA REHABILITATION CENTER, INC
Doing business as
ABA Med Group
Practice address
3850 SW 87TH Ave Ste 104
Miami, FL 33165-5472
Phone
(305) 456-1766
Fax
(305) 456-6443
NPI assigned
Nov 5, 2018
Last updated
Sep 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Authorized official

Name
Jenry Urdanivia, MANPI 1689712754
Title
Owner
Phone
(305) 456-1766

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

3850 SW 87TH Ave Ste 104
Miami, FL 33165-5472

Mailing address

3850 SW 87TH Ave Ste 104
Miami, FL 33165-5472
Phone (305) 456-1766

Other names 1

  • ABA MED GROUP Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190724002345 FL Part B Supplier - Clinic/Group Practice 5395071690 Receives reassigned benefits from 6 practitioners
Practice locations: Miami, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2301550ABA Rehabilitation Center Inc3850 SW 87TH Ave Ste 104, Miami, FL 33165Certificate of waiverMar 26, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1541376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790553600000",
    "number": "1770051047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 SW 87TH AVE STE 104",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331655472",
            "telephone_number": "305-456-1766",
            "fax_number": "305-456-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 SW 87TH AVE STE 104",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331655472",
            "telephone_number": "305-456-1766",
            "fax_number": "305-456-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABA REHABILITATION CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-05",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A",
        "authorized_official_last_name": "URDANIVIA",
        "authorized_official_first_name": "JENRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-456-1766",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABA MED GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.