MEDICARE: ZANDALEE ELLIOTT BCABA

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	106E00000X	Assistant Behavior Analyst	02516490	FL

General Provider Information

NPI Number	:	1528905841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZANDALEE ELLIOTT BCABA

Provider Business Mailing Address
First Line	:	225 MAIN ST STE 3
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32541-2550
Country	:	US
Telephone Number	:	850-781-0406
Fax Number	:	850-378-5233

Provider Business Practice Location Address
First Line	:	225 MAIN ST STE 3
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32541-2550
Country	:	US
Telephone Number	:	850-781-0406
Fax Number	:	850-378-5233

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

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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Directions to “ ZANDALEE ELLIOTT BCABA” Practice Location

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