Healthcare Provider Details

I. General information

NPI: 1083070577
Provider Name (Legal Business Name): AMELIA NELSON BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6973 UNIVERSITY BLVD
WINTER PARK FL
32792-6713
US

IV. Provider business mailing address

500 E COLONIAL DR
ORLANDO FL
32803-4510
US

V. Phone/Fax

Practice location:
  • Phone: 888-754-0398
  • Fax: 954-982-6491
Mailing address:
  • Phone: 407-218-4340
  • Fax: 407-218-4303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-37568
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: