Healthcare Provider Details
I. General information
NPI: 1053175919
Provider Name (Legal Business Name): OLIVIA OLIVA SARMIENTO BCBA 1-26-2832468
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/12/2024
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1710 DURDEN PKWY
CAPE CORAL FL
33909-6124
US
IV. Provider business mailing address
1710 DURDEN PKWY
CAPE CORAL FL
33909-6124
US
V. Phone/Fax
- Phone: 305-300-5278
- Fax:
- Phone: 305-300-5278
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | BCBA-1-26-2832468 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | RBT-24-326369 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: