MEDICARE: ISIS CAROLINE CHAVES RBT-23-318231

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1790554442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISIS CAROLINE CHAVES RBT-23-318231

Provider Business Mailing Address
First Line	:	7109 YACHT BASIN AVE APT 421
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-6614
Country	:	US
Telephone Number	:	407-470-0958
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 S HIAWASSEE RD STE 203
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-6317
Country	:	US
Telephone Number	:	407-286-4031
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2023
Last Update Date	:	12/12/2025

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