Healthcare Provider Details

I. General information

NPI: 1396363792
Provider Name (Legal Business Name): SOUTH FLORIDA BBF INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2020
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SE 2ND PL
GAINESVILLE FL
32601-1807
US

IV. Provider business mailing address

101 SE 2ND PL E201F
GAIESVILLE FL
33601
US

V. Phone/Fax

Practice location:
  • Phone: 954-532-2195
  • Fax: 305-564-8831
Mailing address:
  • Phone: 786-715-3109
  • Fax: 305-564-8831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: SOLANGEL PADRON
Title or Position: VP
Credential: BCBA
Phone: 549-532-2195