Healthcare Provider Details

I. General information

NPI: 1124983754
Provider Name (Legal Business Name): ADA SAHILY SEGNINI BRIZUELA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6452 CROPPING ST APT 4102
WINTER GARDEN FL
34787-8726
US

IV. Provider business mailing address

6452 CROPPING ST APT 4102
WINTER GARDEN FL
34787-8726
US

V. Phone/Fax

Practice location:
  • Phone: 407-486-2427
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-468767
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: