MEDICARE: MISS SAMINTHA CYNDY JEUDY

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		FL
2	103K00000X	Behavior Analyst	1-26-90171	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	:	1669143657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SAMINTHA CYNDY JEUDY

Provider Business Mailing Address
First Line	:	6342 POLK ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-7730
Country	:	US
Telephone Number	:	754-245-7696
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 NW 150TH AVE STE 2112
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-2870
Country	:	US
Telephone Number	:	754-264-8779
Fax Number	:

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

Provider Enumeration Date	:	09/21/2021
Last Update Date	:	06/02/2026

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