Provider Demographics
NPI:1699498113
Name:FLORIDA PRIME ABA NETWORK INC
Entity type:Organization
Organization Name:FLORIDA PRIME ABA NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLAING
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-566-3000
Mailing Address - Street 1:3825 HENDERSON BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5021
Mailing Address - Country:US
Mailing Address - Phone:813-566-3000
Mailing Address - Fax:
Practice Address - Street 1:3825 HENDERSON BLVD STE 306
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5021
Practice Address - Country:US
Practice Address - Phone:813-566-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Multi-Specialty