Healthcare Provider Details

I. General information

NPI: 1083520027
Provider Name (Legal Business Name): CHAMPION KIDS BEHAVIORAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7806 SKYVIEW DR
ORLANDO FL
32809-7065
US

IV. Provider business mailing address

7806 SKYVIEW DR
ORLANDO FL
32809-7065
US

V. Phone/Fax

Practice location:
  • Phone: 407-436-9386
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: NORMILE JOHN BERRY
Title or Position: OWNER
Credential:
Phone: 407-436-9386