MEDICARE: SYSTEMATIC BUSINESS SOLUTIONS

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	1020909	FL

General Provider Information

NPI Number	:	1740541838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYSTEMATIC BUSINESS SOLUTIONS

Provider Business Mailing Address
First Line	:	275 MURCIA DR
Second Line	:	APT 302
City	:	JUPITER
State	:	FL
Zip	:	33458-2748
Country	:	US
Telephone Number	:	321-720-3996
Fax Number	:

Provider Business Practice Location Address
First Line	:	1080 E INDIANTOWN RD
Second Line	:	SUITE 101
City	:	JUPITER
State	:	FL
Zip	:	33477-5100
Country	:	US
Telephone Number	:	321-720-3996
Fax Number	:	186-695-9675

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JENNIFER KONDASH
Credential	:
Telephone Number	:	321-720-3996

Provider Enumeration Date	:	06/05/2012
Last Update Date	:	06/05/2012

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