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Organization

ADVANCED BEHAVIOR CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRACILIA PEREZ FERNANDEZ (OWNER)
(813) 454-2252
Entity
Organization

Contact information

Practice address
5108 N HABANA AVE STE 1&2, TAMPA, FL 33614-6822
(813) 533-0011
Mailing address
5108 N HABANA AVE STE 1&2, TAMPA, FL 33614-6822
(813) 533-0011

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
2084P0800X
Psychiatry Physician
261QC1500X
Community Health Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
08/06/2018
Last updated
01/28/2020
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