Provider Demographics
NPI:1740896497
Name:ORLANDO BEHAVIOR THERAPY AT CENTRAL FLORIDA LLC
Entity type:Organization
Organization Name:ORLANDO BEHAVIOR THERAPY AT CENTRAL FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:RODRIGUEZ GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:786-399-6000
Mailing Address - Street 1:6311 BRENTON POINTE CV
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-8020
Mailing Address - Country:US
Mailing Address - Phone:786-399-3600
Mailing Address - Fax:
Practice Address - Street 1:6311 BRENTON POINTE CV
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32829-8020
Practice Address - Country:US
Practice Address - Phone:786-399-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-18
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty