NPIMap

Organization Active NPI

Club Spectrum ABA

  • Adolescent and Children Mental Health Clinic/Center
  • Orlando, FL
National Provider Identifier
1407592900
Registry record updated May 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
CLUB SPECTRUM ABA
Practice address
3700 Curry Ford Rd Apt M8
Orlando, FL 32806-2641
Phone
(407) 369-3788
NPI assigned
May 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2022

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

Authorized official

Name
Cori-Anne Bonfilio, BCBANPI 1730682105
Title
Founder Ceo
Phone
(407) 369-3788

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

3700 Curry Ford Rd Apt M8
Orlando, FL 32806-2641

Mailing address

3700 Curry Ford Rd Apt M8
Orlando, FL 32806-2641
Phone (407) 369-3788

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address coribonfilio@clubspectrumaba.com Direct

National Provider Directory

National Provider Directory

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": "1651968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651968000000",
    "number": "1407592900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 CURRY FORD RD APT M8",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062641",
            "telephone_number": "407-369-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 CURRY FORD RD APT M8",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062641",
            "telephone_number": "407-369-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLUB SPECTRUM ABA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-08",
        "last_updated": "2022-05-08",
        "certification_date": "2022-05-08",
        "status": "A",
        "authorized_official_last_name": "BONFILIO",
        "authorized_official_first_name": "CORI-ANNE",
        "authorized_official_title_or_position": "FOUNDER CEO",
        "authorized_official_telephone_number": "407-369-3788",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "coribonfilio@clubspectrumaba.com",
            "affiliation": "N",
            "endpointDescription": "company email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3700 Curry Ford Rd Apt M8",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328062641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2022; 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.