Provider Demographics
NPI:1710319652
Name:FOUNDART INC.
Entity Type:Organization
Organization Name:FOUNDART INC.
Other - Org Name:FOUNDART ACADEMY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER/PROJECT DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:EDMUNDO
Authorized Official - Last Name:BLUMTRITT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-406-3689
Mailing Address - Street 1:2475 NW 95TH AVE
Mailing Address - Street 2:SUITE 1 & 2
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2337
Mailing Address - Country:US
Mailing Address - Phone:305-406-3689
Mailing Address - Fax:
Practice Address - Street 1:10200 NW 25TH ST STE 204
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-5922
Practice Address - Country:US
Practice Address - Phone:305-406-3689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8888101YM0800X
FL0051701103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty