Healthcare Provider Details

I. General information

NPI: 1003383837
Provider Name (Legal Business Name): REBECCA DELL'ERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2018
Last Update Date: 08/30/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 PATRICK ST
KISSIMMEE FL
34741-5639
US

IV. Provider business mailing address

809 PATRICK ST
KISSIMMEE FL
34741-5639
US

V. Phone/Fax

Practice location:
  • Phone: 321-401-7026
  • Fax: 321-401-7026
Mailing address:
  • Phone: 321-401-7026
  • Fax: 321-401-7026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: