Provider Demographics
NPI:1487287439
Name:PALM BEACH AUTISM SPECIALISTS, LLC
Entity type:Organization
Organization Name:PALM BEACH AUTISM SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /BCBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBRINO SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA,CAS
Authorized Official - Phone:954-740-2470
Mailing Address - Street 1:345 JUPITER LAKES BLVD STE 302B
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7100
Mailing Address - Country:US
Mailing Address - Phone:954-702-8488
Mailing Address - Fax:
Practice Address - Street 1:345 JUPITER LAKES BLVD STE 302B
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7100
Practice Address - Country:US
Practice Address - Phone:954-702-8488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty