NPIMap

Organization Active NPI

Advanced Behavior Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tampa, FL
National Provider Identifier
1205314804
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
ADVANCED BEHAVIOR CENTER INC
Practice address
5108 N Habana Ave Ste 1&2
Tampa, FL 33614-6822
Phone
(813) 533-0011
NPI assigned
Aug 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gracilia Perez FernandezNPI 1891268728
Title
Owner
Phone
(813) 454-2252

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Community Health Clinic/Center 261QC1500X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

5108 N Habana Ave Ste 1&2
Tampa, FL 33614-6822

Mailing address

5108 N Habana Ave Ste 1&2
Tampa, FL 33614-6822
Phone (813) 533-0011

National Provider Directory

National Provider Directory

Locations

5108 N Habana Ave
Ste 12
Tampa, FL 33614
Phone (813) 533-0011

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1205314804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 N HABANA AVE STE 1&2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146822",
            "telephone_number": "813-533-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 N HABANA AVE STE 1&2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146822",
            "telephone_number": "813-533-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED BEHAVIOR CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-06",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "PEREZ FERNANDEZ",
        "authorized_official_first_name": "GRACILIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-454-2252"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.