| Fst Behavioral | |
|
606 S 9th St Leesburg FL 34748-6320 | |
| (800) 378-7597 | |
| Not Available |
| Full Name | Fst Behavioral |
|---|---|
| Speciality | Behavior Analyst |
| Location | 606 S 9th St, Leesburg, Florida |
| Authorized Official Name and Position | Federico Nicholas (COO) |
| Authorized Official Contact | 4075305063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fst Behavioral 1650 Sand Lake Rd Ste 230 Orlando FL 32809-9138 Ph: () - | Fst Behavioral 606 S 9th St Leesburg FL 34748-6320 Ph: (800) 378-7597 |
| NPI Number | 1114733581 |
|---|---|
| Provider Enumeration Date | 12/10/2024 |
| Last Update Date | 12/10/2024 |
| Certification Date | 12/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114733581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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