Healthcare Provider Details

I. General information

NPI: 1942626643
Provider Name (Legal Business Name): EXCELLERATED TEACHING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2014
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 N KENDALL DR STE 807F
KENDALL FL
33156-7564
US

IV. Provider business mailing address

1900 GANDY BLVD N # 200
ST PETERSBURG FL
33702-2139
US

V. Phone/Fax

Practice location:
  • Phone: 727-748-4060
  • Fax: 727-748-4060
Mailing address:
  • Phone: 727-748-4060
  • Fax: 727-748-4060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0-13-5494
License Number StateFL

VIII. Authorized Official

Name: MR. ROBERT JONES HASBROUCK
Title or Position: OWNER
Credential:
Phone: 727-686-1142