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NPI Code Detail

MEDICARE: MR. ANDREW JACOB BETHKE

MEDICARE: MR. ANDREW JACOB BETHKE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-21-50633FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144746298
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDREW JACOB BETHKE
Provider Business Mailing Address
First Line : 1865 FRIDAY RD
Second Line :
City : COCOA
State : FL
Zip : 32926-3409
Country : US
Telephone Number : 321-888-3020
Fax Number : 661-263-4584
Provider Business Practice Location Address
First Line : 1865 FRIDAY RD
Second Line :
City : COCOA
State : FL
Zip : 32926-3409
Country : US
Telephone Number : 321-888-3020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2017
Last Update Date : 10/02/2025

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