Healthcare Provider Details

I. General information

NPI: 1871456145
Provider Name (Legal Business Name): AWESOMETISM BRAIN TRAIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 AMBERGRIS DR
ORLANDO FL
32822
US

IV. Provider business mailing address

100 E PINE ST STE 110
ORLANDO FL
32801-2759
US

V. Phone/Fax

Practice location:
  • Phone: 352-667-5576
  • Fax:
Mailing address:
  • Phone: 352-667-5576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SAHAR YASSER HASSANE
Title or Position: FOUNDER
Credential: M.ED., BCBA, LBA
Phone: 352-667-5576