Healthcare Provider Details

I. General information

NPI: 1861339160
Provider Name (Legal Business Name): YODELEY MARCHAND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8390 CHAMPIONS GATE BLVD STE 110
CHAMPIONS GATE FL
33896-8311
US

IV. Provider business mailing address

207 CANNA DR
DAVENPORT FL
33897-3820
US

V. Phone/Fax

Practice location:
  • Phone: 407-753-7932
  • Fax:
Mailing address:
  • Phone: 305-224-2524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: