A SPECTRUM OF SUCCESS INC — NPI 1528894094 (Licensed & Credentialed Behavior Analyst in PLANTATION, FL)

CMS-1500 Box 24J / 33a • NPI

1528894094

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

103K00000X

Licensed & Credentialed Behavior Analyst

Box 32 Service Location & ZIP+4

205 SW 84TH AVE, PLANTATION, FL, 33324-2708

✓ 9-Digit EDI 837 ZIP+4 (33324-2708)

Practice Phone & Referral Fax

(954) 382-5570

Fax: (954) 250-2529

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1528894094 (A SPECTRUM OF SUCCESS INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1528894094` (NPI-2 Organization / Facility)
Provider / Legal Name	A SPECTRUM OF SUCCESS INC
Plain-English Specialty	Licensed & Credentialed Behavior Analyst NUCC Code: `103K00000X` (Behavior Analyst)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	205 SW 84TH AVE, PLANTATION, FL, 33324-2708
Practice Telephone / Fax	Tel: (954) 382-5570 \| Fax: (954) 250-2529
Administrative Mailing Address	205 SW 84TH AVE, PLANTATION, FL, 33324-2708
Enumeration & Last Sync	Enumerated: 2024-09-11 \| CMS Record Updated: 2024-09-11
Authorized Official	MIDELKIS SERRA (President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

205 SW 84TH AVE, PLANTATION, FL, 33324-2708

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Plain-English Taxonomy & CMS Crosswalk (103K00000X)

What Does Taxonomy Code 103K00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103K00000X translates to:
"Licensed & Credentialed Behavior Analyst"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Behavior Analyst for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (A SPECTRUM OF SUCCESS INC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103K00000X` — Behavior Analyst Plain English: Licensed & Credentialed Behavior Analyst	State: N/A \| License: `Verified` \| Primary: Yes (Primary)
`251S00000X` — Community/Behavioral Health Plain English: Licensed & Credentialed Community/Behavioral Health	State: N/A \| License: `Verified` \| Primary: Secondary
`261QH0700X` — Clinic/Center, Hearing and Speech Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Secondary
`261QX0100X` — Clinic/Center, Occupational Medicine Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Secondary

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A SPECTRUM OF SUCCESS INC (NPI #1528894094)