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General NPI Number Information
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NPI Number | 1376699447
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH CONSULTANTS
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3240 WATERMAN WAY
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City | TAVARES
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State | FL
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Zip | 32778-5243
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Country | US
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Telephone | 352-253-3739
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Fax | 352-253-3735
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Provider Business Mailing Address
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Address Line | PO BOX 1188
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City | TAVARES
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State | FL
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Zip | 32778-1188
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Country | US
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Telephone | 352-253-3739
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Fax | 352-253-3735
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Authorized Official
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Title or Position | CFO
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Name | MR. RONALD K BENFIELD
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Credential |
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Telephone | 352-253-3739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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