Healthcare Provider Details

I. General information

NPI: 1447998018
Provider Name (Legal Business Name): TBI ASSESSMENT GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2022
Last Update Date: 05/24/2022
Certification Date: 05/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 S ORANGE AVE STE 1585
ORLANDO FL
32801-3221
US

IV. Provider business mailing address

121 S ORANGE AVE STE 1585
ORLANDO FL
32801-3221
US

V. Phone/Fax

Practice location:
  • Phone: 407-377-6868
  • Fax:
Mailing address:
  • Phone: 407-377-6868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK INAD HADDAD
Title or Position: PRESIDENT
Credential:
Phone: 407-377-6868