Healthcare Provider Details

I. General information

NPI: 1174457303
Provider Name (Legal Business Name): NYLIYAH ZONA DAWKINS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 DAFFODIL DR SW APT 107
PALM BAY FL
32908-3368
US

IV. Provider business mailing address

183 DAFFODIL DR SW APT 107
PALM BAY FL
32908-3368
US

V. Phone/Fax

Practice location:
  • Phone: 321-243-0963
  • Fax:
Mailing address:
  • Phone: 321-243-0963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-543108
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: