Organization

Adly Thebaud,md,pa

May also be knows as Family Psychiatry Services

Community/Behavioral Health Agency in Orange City, FL(View on Map)

Legal Business Name

Adly Thebaud,md,pa

Also Known As

Family Psychiatry Services

NPI Number

1417018482

NPI Type

Organization

Enumeration Date

12/13/2006

Specialties

(Taxonomies)

Licenses

State

Florida
Florida
Florida

License Number

ME60436
ARNP 9410846
ARNP 9231203

Contact
Information

Purpose

Mailing
Location

Address

2725 REBECCA LN STE 107
2725 REBECCA LN STE 107

City

Orange City
Orange City

State

FL
FL

Postal Code

32763-8350
32763-8350

Country

US
US

Telephone Number

(386) 775-0736
(386) 775-0736

Authorized Official

Name

Dr. Adly Thebaud

Title or Position

OWNER

Telephone Number

(386) 775-0736

Identifiers

Identifier

K0231
010364600

Identifier State

FL
FL

Identifier Issuer

MEDICARE
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/09/2023

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