Blue Horizon Professional Group, Inc

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

Legal business name

BLUE HORIZON PROFESSIONAL GROUP, INC

Practice address

1591 Hayley LN Ste 101
Fort Myers, FL 33907-2121

Phone

(239) 288-6046

Fax

(888) 388-5055

NPI assigned

Feb 26, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Rolando Davila

Title

Ceo

Phone

(239) 288-6046

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Blue Horizon Professional Group Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Blue Horizon Professional Group

  • Behavior Analyst
  • Fort Myers, FL
  • NPI 1588368864
  NPD tax ID
• Blue Horizon Professional Group, Inc

  • Behavior Analyst
  • Lehigh Acres, FL
  • NPI 1932871571
  NPD tax ID

Locations

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1508323684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1591 HAYLEY LN",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072121",
            "telephone_number": "239-288-6046",
            "fax_number": "888-388-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 HAYLEY LN STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072121",
            "telephone_number": "239-288-6046",
            "fax_number": "888-388-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HORIZON PROFESSIONAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-26",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "DAVILA",
        "authorized_official_first_name": "ROLANDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "239-288-6046",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568930915",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assistant Behavior Analyst in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Assistant Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.