# FULLER & ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114426400
- **Authorized official:** MICHAEL FULLER MS (OWNER)
- **Authorized official phone:** (407) 716-7669

## Contact information

- **Practice address:** 1743 GAY DR, ORLANDO, FL 32803-1914
- **Practice address phone:** (407) 716-7669
- **Practice address fax:** (407) 641-9615
- **Mailing address:** 1743 GAY DR, ORLANDO, FL 32803-1914
- **Mailing address phone:** (407) 716-7669
- **Mailing address fax:** (407) 641-9615

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/02/2018
- **Last updated:** 02/02/2018