Sunshine State Behavior Analysis LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SUNSHINE STATE BEHAVIOR ANALYSIS LLC

Practice address

210 White Marsh Dr
Ponte Vedra, FL 32081-6096

Phone

(904) 553-1541

NPI assigned

Feb 28, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Travis Heath Ross, BCBA

Title

Behavior Analyst/Owner

Phone

(904) 553-1541

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1689114308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WHITE MARSH DR",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320816096",
            "telephone_number": "904-553-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WHITE MARSH DR",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320816096",
            "telephone_number": "904-553-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE STATE BEHAVIOR ANALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-28",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "HEATH",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST/OWNER",
        "authorized_official_telephone_number": "904-553-1541",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Ponte Vedra, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.