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General NPI Number Information
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NPI Number | 1841861440
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Entity Type | Organization
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Legal Business Name | FLORIDA DBT GROUP, INC.
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Dates
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Enumeration Date | 07/05/2021
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Last Update Date | 07/05/2021
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Provider Practice Location Address
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Address Line | 2572 W STATE ROAD 426 STE 2024
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City | OVIEDO
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State | FL
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Zip | 32765-8389
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Country | US
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Telephone | 321-765-9089
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Fax |
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Provider Business Mailing Address
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Address Line | 2572 W STATE ROAD 426 STE 2024
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City | OVIEDO
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State | FL
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Zip | 32765-8389
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Country | US
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Telephone | 321-765-9089
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Fax |
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Authorized Official
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Title or Position | CO-PRESIDENT
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Name | KRISTAL POLLACK
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Credential |
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Telephone | 321-765-9089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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