Ismael Awadalla

Individual provider Active NPI Behavior Technician · Mount Dora, FL

NPI 1508635673 · NPPES record last updated Dec 29, 2023

Key facts

NPI
1508635673
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
6909 Old Highway 41 S
Suite 119
Mount Dora, FL 32757
Phone
(352) 358-5001
NPI assigned
Dec 29, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

6909 Old Highway 41 S
Suite 119
Mount Dora, FL 32757

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885

Other providers in Mount Dora, FL

All providers in Mount Dora, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.