Provider Demographics
NPI:1235360660
Name:MCINTYRE, JASON (BEHAVIOR ANALYSTS)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:BEHAVIOR ANALYSTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9719 WINDER TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-2720
Mailing Address - Country:US
Mailing Address - Phone:407-483-9520
Mailing Address - Fax:407-483-9551
Practice Address - Street 1:809 E OAK ST
Practice Address - Street 2:SUITE 106
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-5834
Practice Address - Country:US
Practice Address - Phone:407-483-9520
Practice Address - Fax:407-483-9551
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-01-0562103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1-010562OtherBEHAVIOR CERTIFICATION