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NPI Code Detail

MEDICARE: SHEA ELLIS RBT

MEDICARE: SHEA ELLIS RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1639959828
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEA ELLIS RBT
Provider Business Mailing Address
First Line : 350 ACCEPTANCE WAY
Second Line :
City : CLERMONT
State : FL
Zip : 34711-2788
Country : US
Telephone Number : 352-223-1999
Fax Number :
Provider Business Practice Location Address
First Line : 350 ACCEPTANCE WAY
Second Line :
City : CLERMONT
State : FL
Zip : 34711-2788
Country : US
Telephone Number : 352-223-1999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2023
Last Update Date : 05/06/2026

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Directions to “ SHEA ELLIS RBT” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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