MEDICARE: YORDANKA MEZAWI BCBA

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
1	103K00000X	Behavior Analyst	BACB480273	FL

General Provider Information

NPI Number	:	1164198511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YORDANKA MEZAWI BCBA

Provider Business Mailing Address
First Line	:	24298 SW 113TH PSGE
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33032-7108
Country	:	US
Telephone Number	:	786-202-1701
Fax Number	:	305-614-0428

Provider Business Practice Location Address
First Line	:	2001 SW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-2540
Country	:	US
Telephone Number	:	786-202-1701
Fax Number	:	305-614-0428

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	06/16/2026

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