Healthcare Provider Details

I. General information

NPI: 1164302139
Provider Name (Legal Business Name): MOMENTUM PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 NE PENLYNN AVE
PORT SAINT LUCIE FL
34983-1722
US

IV. Provider business mailing address

103 NE PENLYNN AVE
PORT SAINT LUCIE FL
34983-1722
US

V. Phone/Fax

Practice location:
  • Phone: 407-860-1079
  • Fax: 501-361-1385
Mailing address:
  • Phone: 407-860-1079
  • Fax: 501-361-1385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DONALD WEBB
Title or Position: COO
Credential: BCBA
Phone: 407-860-1079