Healthcare Provider Details

I. General information

NPI: 1851807598
Provider Name (Legal Business Name): YAYLEEN GANDIA MONTIJO MA. BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2017
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3831 W VINE ST STE 60
KISSIMMEE FL
34741-4650
US

IV. Provider business mailing address

1500 S DOUGLAS RD STE 230
CORAL GABLES FL
33134-4108
US

V. Phone/Fax

Practice location:
  • Phone: 407-559-4854
  • Fax:
Mailing address:
  • Phone: 844-244-1818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-84612
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: