MEDICARE: BETHKE BEHAVIOR SERVICES LLC

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

Other Identifiers

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

General Provider Information

NPI Number	:	1548115629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETHKE BEHAVIOR SERVICES LLC

Provider Business Mailing Address
First Line	:	14330 LAKE UNDERHILL RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828
Country	:	US
Telephone Number	:	661-435-2750
Fax Number	:

Provider Business Practice Location Address
First Line	:	14330 LAKE UNDERHILL RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-8159
Country	:	US
Telephone Number	:	661-435-2750
Fax Number	:

Authorized Official
Title or Position	:	BCBA
Name	:	MR. ANDREW JACOB BETHKE
Credential	:	M.S., BCBA
Telephone Number	:	661-435-2750

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “BETHKE BEHAVIOR SERVICES LLC ” Practice Location

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