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NPI Code Detail

MEDICARE: EARLY ABA & ACADEMIC INTERVENTION INC.

MEDICARE: EARLY ABA & ACADEMIC INTERVENTION INC.
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
1103TC1900XCounseling Psychologist
2251S00000XCommunity/Behavioral Health Agency
3103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750929774
Entity Type Code : Organization
Provider Name (Legal Business Name) : EARLY ABA & ACADEMIC INTERVENTION INC.
Provider Business Mailing Address
First Line : 8378 LUDINGTON CIR
Second Line :
City : ORLANDO
State : FL
Zip : 32836-5910
Country : US
Telephone Number : 305-202-3081
Fax Number :
Provider Business Practice Location Address
First Line : 730 SAND LAKE RD STE 176
Second Line :
City : ORLANDO
State : FL
Zip : 32809-7747
Country : US
Telephone Number : 305-202-3081
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DWAYNE DENZEL NEBLETT
Credential :
Telephone Number : 305-202-3081
Provider Enumeration Date : 12/20/2019
Last Update Date : 04/16/2026

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