MEDICARE: TBI ASSESSMENT GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1447998018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TBI ASSESSMENT GROUP LLC

Provider Business Mailing Address
First Line	:	121 S ORANGE AVE STE 1585
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-3221
Country	:	US
Telephone Number	:	407-377-6868
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 S ORANGE AVE STE 1585
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-3221
Country	:	US
Telephone Number	:	407-377-6868
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PATRICK INAD HADDAD
Credential	:
Telephone Number	:	407-377-6868

Provider Enumeration Date	:	05/24/2022
Last Update Date	:	05/24/2022

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Directions to “TBI ASSESSMENT GROUP LLC ” Practice Location

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