Healthcare Provider Details

I. General information

NPI: 1699630947
Provider Name (Legal Business Name): REBECCA ZEILLEMAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

124 E MIRACLE STRIP PKWY STE 503
MARY ESTHER FL
32569-1991
US

IV. Provider business mailing address

2120 ANDORRA ST
NAVARRE FL
32566-9114
US

V. Phone/Fax

Practice location:
  • Phone: 850-301-0438
  • Fax:
Mailing address:
  • Phone: 850-218-0110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-501211
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: