Healthcare Provider Details

I. General information

NPI: 1366615247
Provider Name (Legal Business Name): EAP GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2256 WINTER WOODS BLVD 2256
WINTER PARK FL
32792-1955
US

IV. Provider business mailing address

2256 WINTER WOODS BLVD 2256
WINTER PARK FL
32792-1955
US

V. Phone/Fax

Practice location:
  • Phone: 407-740-7105
  • Fax: 407-740-0372
Mailing address:
  • Phone: 407-740-7105
  • Fax: 407-740-0372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW# 186
License Number StateFL

VIII. Authorized Official

Name: MR. GERARD PAUL KINZLER
Title or Position: PRESIDENT
Credential: MSW,LCSW
Phone: 407-740-7105