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Organization
TAMPA BAY BEHAVIORAL HEALTH SERVICES INC
Active
Organization
TAMPA BAY BEHAVIORAL HEALTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE M MARTINEZ (PRESIDENT)
(786) 663-2607
Entity
Organization
Contact information
Practice address
4147 W WATERS AVE, TAMPA, FL 33614-8116
(786) 663-2607
Mailing address
4147 W WATERS AVE, TAMPA, FL 33614-8116
(786) 663-2607
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
11/29/2017
Last updated
11/29/2017
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