Healthcare Provider Details

I. General information

NPI: 1881060309
Provider Name (Legal Business Name): PAPER AIRPLANE BEHAVIORAL SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11653 CENTRAL PKWY STE 206
JACKSONVILLE FL
32224-2711
US

IV. Provider business mailing address

11653 CENTRAL PKWY STE 206
JACKSONVILLE FL
32224-2711
US

V. Phone/Fax

Practice location:
  • Phone: 229-630-2303
  • Fax:
Mailing address:
  • Phone: 904-417-8395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MISS MARCELLE ROSALIA MEDINASMESTER
Title or Position: FOUNDER AND BEHAVIOR ANALYST
Credential: BCBA
Phone: 904-417-8395