Provider Demographics
NPI:1437518743
Name:OBEN HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:OBEN HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:
Authorized Official - Last Name:OBEN-CUADROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-361-4173
Mailing Address - Street 1:28844 RAINDANCE AVE
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-6422
Mailing Address - Country:US
Mailing Address - Phone:787-361-4173
Mailing Address - Fax:
Practice Address - Street 1:710 OAKFIELD DR STE 153
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4954
Practice Address - Country:US
Practice Address - Phone:813-654-0503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 9486251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPY 9486OtherLICENSED PSYCHOLOGIST