<Unavail>

LBN: Adly Thebaud,Md,Pa
<Unavail> is an health care organization with primary practice located at 2725 Rebecca Ln Ste 107 , Orange City FL 32763-8350. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Agencies / Community/Behavioral Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Agencies / Community/Behavioral Health is the primary health care specialty. Adly Thebaud,Md,Pa can be contacted via phone (386) 775-0736, or through Thebaud, Adly via phone (386) 775-0736.

Contact Information

Primary practice address
2725 Rebecca Ln Ste 107 Orange City FL 32763-8350
Phone: (386) 775-0736
Fax: (386) 775-0738
Website:
Map and Directions
Authorized official contact:
Name: Thebaud, Adly
Phone: (386) 775-0736

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X ME60436 Florida
Agencies / Community/Behavioral Health 251S00000X Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X ARNP 9410846 Florida

Profile Details

NPI number 1417018482
LBN Legal business name Adly Thebaud,Md,Pa
DBA Doing business as <Unavail>
Authorized official Thebaud, Adly
Entity Organization
Organization subpart 1 No
Enumeration date Dec 13th, 2006
Last updated Jun 10th, 2026 - about 4 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417018482 NPPES
Florida MEDICAID 010364600
Florida Other W9584
Florida Other K0231

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