Provider Demographics
NPI:1598595837
Name:TALBERT-IRVING, JAMES EDWARD
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:TALBERT-IRVING
Suffix:
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 1:3976 KNOTT DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-6438
Mailing Address - Country:US
Mailing Address - Phone:407-448-8151
Mailing Address - Fax:
Practice Address - Street 1:601 S LAKE DESTINY RD
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7226
Practice Address - Country:US
Practice Address - Phone:407-618-0495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician