MEDICARE: MS. GUERLYNE BELLEVUE 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	106S00000X	Behavior Technician	RBT-21-166687	FL
2	174400000X	Specialist
3	222Q00000X	Developmental Therapist
4	252Y00000X	Early Intervention Provider Agency
5	106E00000X	Assistant Behavior Analyst	0-25-15869	FL

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	:	1588014088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GUERLYNE BELLEVUE BCABA

Provider Business Mailing Address
First Line	:	428 AUBURN DR APT 102
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32118-3248
Country	:	US
Telephone Number	:	386-216-6184
Fax Number	:	386-206-1145

Provider Business Practice Location Address
First Line	:	428 AUBURN DR APT 102
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32118-3248
Country	:	US
Telephone Number	:	386-216-6184
Fax Number	:	386-206-1145

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

Provider Enumeration Date	:	06/15/2016
Last Update Date	:	03/19/2025

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