Provider Demographics
NPI:1619083276
Name:GIRLS AND BOYS TOWN OF CENTRAL FLORIDA
Entity Type:Organization
Organization Name:GIRLS AND BOYS TOWN OF CENTRAL FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:ZBYLUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-366-3667
Mailing Address - Street 1:37 ALAFAYA WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6233
Mailing Address - Country:US
Mailing Address - Phone:407-366-3667
Mailing Address - Fax:407-365-5397
Practice Address - Street 1:3500 S SANFORD AVE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-5829
Practice Address - Country:US
Practice Address - Phone:407-366-3667
Practice Address - Fax:407-365-5397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty