Organization
THRIVE BEHAVIORAL SCIENCES ORLANDO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOLENE DE LA GARDELLE (VP OPERATIONS)
(813) 277-4571
Entity
Organization
Contact information
Practice address
4700 MILLENIA BLVD STE 500, ORLANDO, FL 32839-6019
(813) 467-6111
Mailing address
5510 N HESPERIDES ST, TAMPA, FL 33614-5414
(813) 277-4571
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
—
—
Other
Enumeration date
02/28/2019
Last updated
08/16/2024
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