MEDICARE: UNIVERSITY BEHAVIORAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician
2	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	4442	FL
3	323P00000X	Psychiatric Residential Treatment Facility	4442	FL
4	283Q00000X	Psychiatric Hospital	4442	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851395263
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY BEHAVIORAL LLC

Provider Business Mailing Address
First Line	:	2500 DISCOVERY DRIVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32826-3709
Country	:	US
Telephone Number	:	407-281-7000
Fax Number	:	407-282-7012

Provider Business Practice Location Address
First Line	:	2500 DISCOVERY DRIVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32826-3709
Country	:	US
Telephone Number	:	407-281-7000
Fax Number	:	407-282-7012

Authorized Official
Title or Position	:	SR VP CFO
Name	:	STEVE FILTON
Credential	:
Telephone Number	:	610-768-3300

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	02/23/2021

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Directions to “UNIVERSITY BEHAVIORAL LLC ” Practice Location

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