MEDICARE: JAMESON LECLAIR RBT

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	L246-545-96-801-0	OTHER	FL	DRIVERS LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619562576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMESON LECLAIR RBT

Provider Business Mailing Address
First Line	:	3200 S HIAWASSEE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-6317
Country	:	US
Telephone Number	:	267-597-1029
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 S HIAWASSEE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-6317
Country	:	US
Telephone Number	:	407-286-4031
Fax Number	:

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

Provider Enumeration Date	:	03/03/2021
Last Update Date	:	01/29/2026

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Directions to “ JAMESON LECLAIR RBT” Practice Location

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