FULLER & ASSOCIATES, LLC (NPI# 1114426400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114426400 |
| Entity Type | Organization |
| Organization Name | FULLER & ASSOCIATES, LLC |
| Practice Address |
1743 Gay Dr Orlando FL 32803-1914 |
| Practice Telephone | 4077167669 |
| Practice Fax Number | 4076419615 |
| Mailing Telephone | 4077167669 |
| Mailing Fax Number | 4076419615 |
| Enumeration Date | 2018-02-02 |
| Last Update Date | 2018-02-02 |
| Authorized Official Name | MICHAEL FULLER (OWNER) |
| Authorized Official Telephone | 4077167669 |
| Authorized Official Credential | MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
1743 GAY DR |
| City | ORLANDO |
| State | FL |
| Zip Code | 32803-1914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568777811 | Michael Eugene Fuller | Counselor | 1743 Gay Dr, Orlando, FL 32803-1914 | 2010-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255952636 | Laiza Souza Tanner | Technician | 500 E Rollins St, Orlando, FL 32803 | 2020-04-27 |
| 1407415342 | Betty Carrol | Marriage & Family Therapist | 1516 E Colonial Dr Ste 100, Orlando, FL 32803 | 2019-06-12 |
| 1326606047 | Anthony Balingit | Physical Therapy Assistant | 1870 Aloma Avenue, Orlando, FL 32803 | 2019-05-29 |
| 1396234795 | Natasha Le Morvan | Technician/Technologist | 1364 Ferris Ave, Orlando, FL 32803 | 2018-05-02 |
| 1306365796 | Sarah E Fischer | Nurse Practitioner | Adventhealth Orlando, 601 E Rollins St, Orlando, FL 32803 | 2017-09-17 |
| 1710404249 | Emilia's Direct Care Agency | Community/Behavioral Health | 3218 E Colonial Dr Rm 118, Orlando, FL 32803 | 2017-08-25 |
| 1760907620 | Kalie Brianne Morris | Speech-Language Pathologist | 1120 Portland Ave Unit 7, Orlando, FL 32803 | 2017-08-11 |
| 1972024271 | Tatiana Ungredda | Psychologist | 5201 Raymond St Ste 424, Orlando, FL 32803 | 2017-06-28 |
| 1063942662 | Michael Thomas | Licensed Practical Nurse | 101 South Bumby Ave, E11, Orlando, FL 32803 | 2017-06-15 |
| 1598209249 | Danielle Marin | Behavioral Analyst | 2807 Edgewater Dr, Orlando, FL 32803 | 2016-12-15 |
| Find all providers in zip 32803 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
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| 1205223054 | Angels for Kids | Clinic/Center | 1020 Honey Blossom Dr, Orlando, FL 32824-4866 | 2015-04-20 |
| 1558785253 | Optumumhealthoutcomes | Clinic/Center | 5104 N Orange Blossom Trl, Suite 108, Orlando, FL 32810-1042 | 2014-02-16 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.