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Organization
FST BEHAVIORAL
Active
Organization
FST BEHAVIORAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FEDERICO NICHOLAS (COO)
(407) 530-5063
Entity
Organization
Contact information
Practice address
4543 PLEASANT HILL RD SPC A, KISSIMMEE, FL 34759-3406
(800) 378-7597
Mailing address
1650 SAND LAKE RD STE 230, ORLANDO, FL 32809-9138
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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