Organization
ALL FLORIDA ABA CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REYDEL LOPEZ MENDEZ (PRESIDENT)
(786) 269-8757
Entity
Organization
Contact information
Practice address
5240 BANK ST STE 14, FORT MYERS, FL 33907-2110
(786) 269-8757
Mailing address
5540 BANK ST, SUIT 14, FORT MYERS, FL 33907
(786) 269-8757
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
11/30/2020
Last updated
01/28/2021
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