Healthcare Provider Details

I. General information

NPI: 1386557536
Provider Name (Legal Business Name): OUT OF THE BOX BEHAVIORAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 N SINCLAIR AVE STE 4
TAVARES FL
32778-2621
US

IV. Provider business mailing address

604 N SINCLAIR AVE STE 4
TAVARES FL
32778-2621
US

V. Phone/Fax

Practice location:
  • Phone: 352-217-8308
  • Fax:
Mailing address:
  • Phone: 352-217-8308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MALENA ABREU SINTES
Title or Position: CLINICAL DIRECTOR
Credential: BCBA
Phone: 352-217-8303