1750023370 NPI number — BEHAVIOR THERAPY OF FLORIDA INC.

Table of content: MATTHEW DAIN BRAITHWAITE MD (NPI 1104280817)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750023370 NPI number — BEHAVIOR THERAPY OF FLORIDA INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEHAVIOR THERAPY OF FLORIDA INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750023370
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5051 CASTELLO DR STE 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34103-8959
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-529-3185
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5051 CASTELLO DR STE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34103-8959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-529-3185
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/13/2022

Additional Information

Authorized Official

Authorized Official Last Name:
VALDES SANTOVENIA
Authorized Official First Name:
BARBARITA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
239-601-4763

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 114599100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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