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222 Broadway Unit 211 Kissimmee FL 34741-5760 | |
| (407) 329-3464 | |
| (407) 386-3344 |
| Full Name | |
|---|---|
| Speciality | Behavior Technician |
| Location | 222 Broadway Unit 211, Kissimmee, Florida |
| Authorized Official Name and Position | Brenda Sanchez (OFFICE MANAGER) |
| Authorized Official Contact | 4073293464 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 452574 Kissimmee FL 34745-2574 Ph: (407) 329-3464 | 222 Broadway Unit 211 Kissimmee FL 34741-5760 Ph: (407) 329-3464 |
| NPI Number | 1174971311 |
|---|---|
| Provider Enumeration Date | 05/27/2016 |
| Last Update Date | 02/26/2024 |
| Certification Date | 02/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174971311 | NPI | - | NPPES |
| 019599700 | Medicaid | FL | |
| 017562100 | Medicaid | FL | |
| 101637400 | Medicaid | FL |
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