Organization
BANYAN SPROUT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLISON PINTO PH.D. (PRESIDENT)
(941) 539-8993
Entity
Organization
Contact information
Practice address
1188 N TAMIAMI TRL, SUITE 205-C, SARASOTA, FL 34236-2414
(941) 539-8993
(941) 362-0452
Mailing address
1188 N TAMIAMI TRL, SUITE 205-C, SARASOTA, FL 34236-2414
(941) 539-8993
(941) 362-0452
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
PY 7193
FL
251S00000X
Community/Behavioral Health Agency
Primary
PY 7193
FL
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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