| Florida Mentor | |
|
2500 Maitland Center Pkwy Suite 314 Maitland FL 32751-7224 | |
| (407) 661-1110 | |
| (407) 661-9777 |
| Full Name | Florida Mentor |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2500 Maitland Center Pkwy, Maitland, Florida |
| Authorized Official Name and Position | Brett Ian Cohen (COO) |
| Authorized Official Contact | 8003885150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Florida Mentor 313 Congress St Boston MA 02210-1218 Ph: (800) 388-5150 | Florida Mentor 2500 Maitland Center Pkwy Suite 314 Maitland FL 32751-7224 Ph: (407) 661-1110 |
| NPI Number | 1740324185 |
|---|---|
| Provider Enumeration Date | 02/19/2007 |
| Last Update Date | 03/19/2023 |
| Certification Date | 03/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740324185 | NPI | - | NPPES |
| 766161400 | Medicaid | FL | |
| 766161401 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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