NPIMap

Organization Active NPI

Florida Mentor

  • Community/Behavioral Health Agency
  • Lakeland, FL
National Provider Identifier
1487039848
Registry record updated Mar 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FLORIDA MENTOR
Practice address
5304 S Florida Ave Ste 206
Lakeland, FL 33813-4918
Phone
(863) 677-4026
NPI assigned
Jul 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2023

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

Authorized official

Name
Brett Ian Cohen
Title
Coo
Phone
(800) 388-5150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

5304 S Florida Ave Ste 206
Lakeland, FL 33813-4918

Mailing address

313 Congress St
Boston, MA 02210-1218
Phone (800) 388-5150

National Provider Directory

National Provider Directory
Tax ID family
California Mentor336 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5304 S Florida Ave
Ste 206
Lakeland, FL 33813
Phone (863) 677-4026

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678579200000",
    "number": "1487039848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 CONGRESS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022101218",
            "telephone_number": "800-388-5150",
            "fax_number": "617-790-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5304 S FLORIDA AVE STE 206",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338134918",
            "telephone_number": "863-677-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA MENTOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2023-03-12",
        "certification_date": "2023-03-12",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "800-388-5150"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2023; 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.