MEDICARE: JENNA PEDLEY 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	RBT-25-498864	FL

General Provider Information

NPI Number	:	1619831047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA PEDLEY RBT

Provider Business Mailing Address
First Line	:	9033 TANGELO BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33967-3734
Country	:	US
Telephone Number	:	239-560-0860
Fax Number	:

Provider Business Practice Location Address
First Line	:	8359 BEACON BLVD STE 416
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-3065
Country	:	US
Telephone Number	:	239-676-3462
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “ JENNA PEDLEY RBT” Practice Location

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