Basic Information
| Provider Information | |||||||||
| NPI: | 1972926517 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED BEHAVIORAL CONSULTANTS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 10430-0430 | ||||||||
| Address2: | |||||||||
| City: | ST. PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278201040 | ||||||||
| FaxNumber: | 7278217213 | ||||||||
| Practice Location | |||||||||
| Address1: | 1839 CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | ST. PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273221054 | ||||||||
| FaxNumber: | 7278217213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2014 | ||||||||
| LastUpdateDate: | 07/20/2016 | ||||||||
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| AuthorizedOfficialLastName: | SABA | ||||||||
| AuthorizedOfficialFirstName: | FADI | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | MD./OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7278201040 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.