| Southeastern Autism Center Llc | |
|
3884 Bannock Ave Tavares FL 32778-9201 | |
| (315) 569-1112 | |
| Not Available |
| Full Name | Southeastern Autism Center Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3884 Bannock Ave, Tavares, Florida |
| Authorized Official Name and Position | Anne Fletcher (BCBA) |
| Authorized Official Contact | 3155691112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeastern Autism Center Llc 3884 Bannock Ave Tavares FL 32778-9201 Ph: (315) 569-1112 | Southeastern Autism Center Llc 3884 Bannock Ave Tavares FL 32778-9201 Ph: (315) 569-1112 |
| NPI Number | 1700679800 |
|---|---|
| Provider Enumeration Date | 05/22/2025 |
| Last Update Date | 05/22/2025 |
| Certification Date | 05/22/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700679800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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