Organization
BLUE HORIZON PROFESSIONAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROLANDO DAVILA (CEO)
(239) 288-6046
Entity
Organization
Contact information
Practice address
1591 HAYLEY LN STE 101, FORT MYERS, FL 33907-2121
(239) 288-6046
(888) 388-5055
Mailing address
1591 HAYLEY LN, FORT MYERS, FL 33907-2121
(239) 288-6046
(888) 388-5055
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568930915
—
FL
Enumeration date
02/26/2019
Last updated
11/18/2020
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