Healthcare Provider Details

I. General information

NPI: 1285318840
Provider Name (Legal Business Name): NICHOLAS DESINOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7075 KINGSPOINTE PKWY STE 14
ORLANDO FL
32819-6542
US

IV. Provider business mailing address

2862 CARDASSI DR
OCOEE FL
34761-5070
US

V. Phone/Fax

Practice location:
  • Phone: 321-732-3723
  • Fax:
Mailing address:
  • Phone: 407-953-4863
  • 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:
Title or Position:
Credential:
Phone: