Healthcare Provider Details

I. General information

NPI: 1487215976
Provider Name (Legal Business Name): AYENDI C POLITE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 E BLOOMINGDALE AVE
BRANDON FL
33511-8155
US

IV. Provider business mailing address

1815 3RD AVE E
PALMETTO FL
34221-3313
US

V. Phone/Fax

Practice location:
  • Phone: 813-655-8159
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88045
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: