Healthcare Provider Details

I. General information

NPI: 1033350111
Provider Name (Legal Business Name): BUHAIN, BUHAIN & CARR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 03/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 GADSEN BLVD
ORLANDO FL
32812-8541
US

IV. Provider business mailing address

1910 GADSEN BLVD
ORLANDO FL
32812-8541
US

V. Phone/Fax

Practice location:
  • Phone: 407-574-8123
  • Fax: 407-403-6713
Mailing address:
  • Phone: 407-574-8123
  • Fax: 407-403-6713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number4433
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8481
License Number StateFL

VIII. Authorized Official

Name: MR. DYLAN JOHN BUHAIN
Title or Position: FOUNDER / CHIEF EXECUTIVE OFFICER
Credential: M.S.
Phone: 407-574-8123