Organization
ADVANCED BEHAVIORAL CARE LLC
Active
Other names
ABC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD BUNT M.D. (MEDICAL DIRECTOR)
(321) 622-3222
Entity
Organization
Contact information
Practice address
911 COLUMBUS AVE, MELBOURNE, FL 32901-4605
(321) 622-3222
Mailing address
911 COLUMBUS AVE, MELBOURNE, FL 32901-4605
(321) 622-3222
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
ME98371
FL
Other
Enumeration date
04/07/2011
Last updated
05/19/2011
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