Healthcare Provider Details

I. General information

NPI: 1871400234
Provider Name (Legal Business Name): YANKO BERMUDEZ VILLA BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10308 BROWNWOOD AVE
ORLANDO FL
32825-6628
US

IV. Provider business mailing address

10308 BROWNWOOD AVE
ORLANDO FL
32825-6628
US

V. Phone/Fax

Practice location:
  • Phone: 203-510-9325
  • Fax: 407-704-2556
Mailing address:
  • Phone: 203-510-9325
  • Fax: 407-704-2556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2841953
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: