Healthcare Provider Details

I. General information

NPI: 1417667213
Provider Name (Legal Business Name): SABRINA AVALOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2022
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S HIAWASSEE RD STE 203
ORLANDO FL
32835-6317
US

IV. Provider business mailing address

1973 BEACON BAY CT
APOPKA FL
32712-8191
US

V. Phone/Fax

Practice location:
  • Phone: 407-286-4031
  • Fax:
Mailing address:
  • Phone: 407-271-7899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-247001
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: