Healthcare Provider Details

I. General information

NPI: 1831821966
Provider Name (Legal Business Name): BLUE CARE BEHAVIOR THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5516 ROBERT SCOTT DR N
JACKSONVILLE FL
32207-5961
US

IV. Provider business mailing address

5516 ROBERT SCOTT DR N
JACKSONVILLE FL
32207-5961
US

V. Phone/Fax

Practice location:
  • Phone: 904-662-7093
  • Fax: 904-506-4340
Mailing address:
  • Phone: 904-662-7093
  • Fax: 904-506-4340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ANAY QUINTERO
Title or Position: OWNER
Credential:
Phone: 786-599-4901