MEDICARE: ADAIR TORMANEN RBT

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	106S00000X	Behavior Technician	RBT-24-358802	FL

General Provider Information

NPI Number	:	1760228589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAIR TORMANEN RBT

Provider Business Mailing Address
First Line	:	4443 BASS PL N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-6000
Country	:	US
Telephone Number	:	904-465-0090
Fax Number	:	904-212-1032

Provider Business Practice Location Address
First Line	:	4443 BASS PL N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-6000
Country	:	US
Telephone Number	:	904-465-0090
Fax Number	:	904-212-1032

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2024
Last Update Date	:	07/02/2024

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Directions to “ ADAIR TORMANEN RBT” Practice Location

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