MEDICARE: SOBEC 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	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467179465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOBEC LLC

Provider Business Mailing Address
First Line	:	5051 MEMORIAL HWY UNIT B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-7355
Country	:	US
Telephone Number	:	786-395-8225
Fax Number	:

Provider Business Practice Location Address
First Line	:	5051 MEMORIAL HWY UNIT B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-7355
Country	:	US
Telephone Number	:	786-395-8225
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANTONIO H PADILLA GALIS MENENDEZ
Credential	:
Telephone Number	:	786-395-8225

Provider Enumeration Date	:	10/20/2022
Last Update Date	:	06/20/2024

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Directions to “SOBEC LLC ” Practice Location

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