Healthcare Provider Details

I. General information

NPI: 1093356347
Provider Name (Legal Business Name): NEFTALI DELGADO-HERNANDEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1631 E VINE ST
KISSIMMEE FL
34744-3728
US

IV. Provider business mailing address

452 LAKE AMBERLEIGH DR
WINTER GARDEN FL
34787-5252
US

V. Phone/Fax

Practice location:
  • Phone: 407-751-8499
  • Fax:
Mailing address:
  • Phone: 407-751-8499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-86456
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2835829
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-21-12375
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: