Nathaly Ascencio
Individual provider Active NPI Behavior Technician · Yulee, FL
NPI 1104734268 · NPPES record last updated Sep 3, 2026
Key facts
- NPI
- 1104734268
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 464099 State Road 200
Yulee, FL 32097-6459 - Phone
- (904) 865-4611
- Fax
- (904) 659-0130
- NPI assigned
- Aug 31, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | FL | Yes |
Addresses
Primary practice location
464099 State Road 200
Yulee, FL 32097-6459
Mailing address
300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Phone (866) 610-0580
Other providers in Yulee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.