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General NPI Number Information
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NPI Number | 1144829557
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Entity Type | Individual
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Provider Name | JONATHAN J NADEAU BCBA
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Gender | Male
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Dates
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Enumeration Date | 10/19/2020
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 7594 W SAND LAKE RD
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City | ORLANDO
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State | FL
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Zip | 32819-5188
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Country | US
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Telephone | 800-875-1871
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Fax | 800-875-1871
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Provider Business Mailing Address
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Address Line | 11983 TAMIAMI TRL N # 121
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City | NAPLES
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State | FL
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Zip | 34110-1603
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Country | US
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Telephone | 800-875-1871
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Fax | 800-875-1871
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-20-44508
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License Number State | FL
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