Provider Demographics
NPI:1700623741
Name:LOUBRIEL, ANTONIO III
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:LOUBRIEL
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 NORTHLAKE BLVD APT 1066
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5255
Mailing Address - Country:US
Mailing Address - Phone:917-653-3551
Mailing Address - Fax:
Practice Address - Street 1:1000 COLOR PL STE 100
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-7718
Practice Address - Country:US
Practice Address - Phone:888-754-0398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician