Healthcare Provider Details
I. General information
NPI: 1376475210
Provider Name (Legal Business Name): LEVINS HERNANDEZ DEVELOPMENTAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
453 KING ST
COCOA FL
32922-7621
US
IV. Provider business mailing address
3594 FODDER DR
ROCKLEDGE FL
32955-6037
US
V. Phone/Fax
- Phone: 321-349-9379
- Fax:
- Phone: 334-707-3213
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOSHUA
SILAS
LEVINS
Title or Position: OWNER
Credential: BCBA
Phone: 334-707-3213