MEDICARE: VASILY BELICHENKO

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	BACB557991	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	:	1942897335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VASILY BELICHENKO

Provider Business Mailing Address
First Line	:	3779 SILVER STAR RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-4627
Country	:	US
Telephone Number	:	407-399-7236
Fax Number	:	407-386-7133

Provider Business Practice Location Address
First Line	:	3779 SILVER STAR RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-4627
Country	:	US
Telephone Number	:	407-399-7236
Fax Number	:

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

Provider Enumeration Date	:	12/31/2020
Last Update Date	:	11/03/2022

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Directions to “ VASILY BELICHENKO ” Practice Location

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