MEDICARE: SHEA PEARL CHESTER

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	:	1811866718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEA PEARL CHESTER

Provider Business Mailing Address
First Line	:	7125 SAND LAKE RESERVE DR APT 3108
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7396
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7125 SAND LAKE RESERVE DR APT 3108
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7396
Country	:	US
Telephone Number	:	570-617-7954
Fax Number	:

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

Provider Enumeration Date	:	10/30/2025
Last Update Date	:	11/28/2025

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Directions to “ SHEA PEARL CHESTER ” Practice Location

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