Healthcare Provider Details

I. General information

NPI: 1619802402
Provider Name (Legal Business Name): JESSICA PIERRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 RIO COVE CT
ORLANDO FL
32825-8315
US

IV. Provider business mailing address

7510 PARK PROMENADE DR
WINTER PARK FL
32792-8500
US

V. Phone/Fax

Practice location:
  • Phone: 407-431-0520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberRBT-26-545464
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: