Provider Demographics
NPI:1013511773
Name:FLORIDA ADVOCACY GROUP, LLC
Entity Type:Organization
Organization Name:FLORIDA ADVOCACY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:K
Authorized Official - Last Name:GODBEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:217-572-2091
Mailing Address - Street 1:17633 GUNN HWY # 230
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-1912
Mailing Address - Country:US
Mailing Address - Phone:813-576-9914
Mailing Address - Fax:813-212-4418
Practice Address - Street 1:7901 4TH ST N STE 300
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4399
Practice Address - Country:US
Practice Address - Phone:813-576-9914
Practice Address - Fax:813-212-4418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty