Provider Demographics
NPI:1831718980
Name:INDIVIDUAL EDUCATION PLAN ACADEMY
Entity type:Organization
Organization Name:INDIVIDUAL EDUCATION PLAN ACADEMY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF STUDENT SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSY
Authorized Official - Middle Name:ROSANNA
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-485-1103
Mailing Address - Street 1:1515 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-3567
Mailing Address - Country:US
Mailing Address - Phone:407-485-1103
Mailing Address - Fax:
Practice Address - Street 1:1515 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-3567
Practice Address - Country:US
Practice Address - Phone:407-485-1103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty
No347C00000XTransportation ServicesPrivate VehicleGroup - Single Specialty