Provider Demographics
NPI:1306247259
Name:KRONFLI, FARIS RASHAD (MA, BCBA)
Entity type:Individual
Prefix:
First Name:FARIS
Middle Name:RASHAD
Last Name:KRONFLI
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 CENTER DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32611-2026
Mailing Address - Country:US
Mailing Address - Phone:352-273-2184
Mailing Address - Fax:
Practice Address - Street 1:945 CENTER DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-2026
Practice Address - Country:US
Practice Address - Phone:352-273-2184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1306192778OtherN/A