Healthcare Provider Details
I. General information
NPI: 1578179370
Provider Name (Legal Business Name): FLUTTERFLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/17/2020
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3020 LAMBERTON BLVD STE 107
ORLANDO FL
32825-9124
US
IV. Provider business mailing address
3020 LAMBERTON BLVD STE 107
ORLANDO FL
32825-9124
US
V. Phone/Fax
- Phone: 407-490-2986
- Fax:
- Phone: 407-490-2986
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOANNA
MELISSA
ACOSTA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MA, BCBA
Phone: 407-534-0033