Provider Demographics
NPI:1760150486
Name:SPRING HEALTH ABA CENTER INC
Entity Type:Organization
Organization Name:SPRING HEALTH ABA CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUAN CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONSO GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-925-7965
Mailing Address - Street 1:1211 TECH BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-7846
Mailing Address - Country:US
Mailing Address - Phone:813-424-1401
Mailing Address - Fax:844-969-3738
Practice Address - Street 1:1211 TECH BLVD STE 114
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-7846
Practice Address - Country:US
Practice Address - Phone:813-424-1401
Practice Address - Fax:844-969-3738
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPRING HEALTH ABA CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-30
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103K00000XMedicaid