Organization
BEHAVIORAL HEALTH SCIENCE OF WEST FLORIDA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TED MARK DORTON (MARKET MANAGER)
(813) 283-8811
Entity
Organization
Contact information
Practice address
508 S HABANA AVE STE 380, TAMPA, FL 33609-4144
(813) 872-0457
(813) 877-7691
Mailing address
508 S HABANA AVE STE 380, TAMPA, FL 33609-4144
(813) 872-0457
(813) 877-7691
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME112401
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME112401
FLORIDA MEDICAL LICENSING BOARD
FL
Enumeration date
01/08/2016
Last updated
01/08/2016
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