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Adly Thebaud,md,pa
Psychiatric/Mental Health Nurse Practitioner in Orange City, Florida
NPI 1417018482

Adly Thebaud,md,pa is a Psychiatric/Mental Health Nurse Practitioner based in Orange City, FL and is specialized in Psychiatric/Mental Health. Adly Thebaud,md,pa practices in Orange City, FL. The NPI Number for Adly Thebaud,md,pa is 1417018482 and holds a License No. ME60436 (Florida).

The current practice location address for Adly Thebaud,md,pa is 2725 Rebecca Ln Ste 107, Orange City, FL and can be reached out via phone at 386-775-0736 and via fax at 386-775-0738.

Location: 2725 Rebecca Ln Ste 107, Orange City, FL, 32763-8350
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1417018482
Provider Name
Adly Thebaud,md,pa
Credential
Provider Entity Type
Organization
Address
2725 Rebecca Ln Ste 107, Orange City, FL, 32763-8350
Phone Number
386-775-0736
Fax Number
386-775-0738
Provider Enumeration Date
12/13/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
K0231 01 FL MEDICARE
010364600 05 FL
institution
Provider Business Practice Location Address Details
Address
2725 Rebecca Ln Ste 107
City
Orange City
State
Florida
Zip
32763-8350
Phone Number
386-775-0736
Fax Number
386-775-0738
person
Provider Business Mailing Address Details
Address
2725 Rebecca Ln Ste 107
City
Orange City
State
Florida
Zip
32763-8350
Phone Number
386-775-0736
Fax Number
386-775-0738
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Child & Adolescent Psychiatry
Taxonomy
2084P0804X
License No.
ARNP 9231203 (Florida)
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
person
Provider's Taxonomy Details 2
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
(Florida)
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
person
Provider's Taxonomy Details 3
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
ME60436 (Florida)
Definition
Definition to come...
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