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NPI Code Detail

MEDICARE: BEHAVIOR ANALYSIS SUPPORT SERVICES, INC

MEDICARE: BEHAVIOR ANALYSIS SUPPORT SERVICES, INC
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
1103K00000XBehavior Analyst

Other Identifiers

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

General Provider Information

NPI Number : 1750027496
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEHAVIOR ANALYSIS SUPPORT SERVICES, INC
Provider Business Mailing Address
First Line : 2035 SW 75TH ST STE B
Second Line :
City : GAINESVILLE
State : FL
Zip : 32607-3425
Country : US
Telephone Number : 877-823-4283
Fax Number : 352-332-8589
Provider Business Practice Location Address
First Line : 50 S BELCHER RD STE 103
Second Line :
City : CLEARWATER
State : FL
Zip : 33765-3948
Country : US
Telephone Number : 877-823-4283
Fax Number : 352-332-8589
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : JOHN DENNIS ADELINIS
Credential :
Telephone Number : 352-332-8588
Provider Enumeration Date : 05/06/2022
Last Update Date : 05/06/2022

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