Provider Demographics
NPI:1093028607
Name:ANTHROPOS FL MENTAL HEALTH & FAMILY THERAPY CENTER, INC
Entity Type:Organization
Organization Name:ANTHROPOS FL MENTAL HEALTH & FAMILY THERAPY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICEPRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ECHEVERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:407-222-4207
Mailing Address - Street 1:1055 PEAK CIR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-6829
Mailing Address - Country:US
Mailing Address - Phone:407-222-4207
Mailing Address - Fax:386-860-0649
Practice Address - Street 1:407 WEKIVA SPRINGS RD
Practice Address - Street 2:SUITE 104
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-6201
Practice Address - Country:US
Practice Address - Phone:407-222-4207
Practice Address - Fax:386-860-0649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-24
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2198106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL692366696Medicaid