Abednerys Abad Heredia
Individual provider Active NPI Behavior Technician · Jacksonville, FL
NPI 1689336372 · NPPES record last updated Oct 3, 2025
Key facts
- NPI
- 1689336372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-21-165058 (FL)
- Practice address
- 12724 Grand Bay Parkway West
Suite 410
Jacksonville, FL 32258-9486 - Phone
- (855) 832-6727
- NPI assigned
- Oct 10, 2021
- Sex
- Female
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-21-165058 | FL | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-21-165058 | FL | Yes |
Addresses
Primary practice location
12724 Grand Bay Parkway West
Suite 410
Jacksonville, FL 32258-9486
Mailing address
12724 Gran Bay Pkwy W Ste 410
Jacksonville, FL 32258-9486
Phone (813) 409-4122
Other providers in Jacksonville, FL
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- Patrick Aaronson
- ABA Brightwings LLC
- Abiedu Charles Abaaba
- Vera Utagah Abaaba
- Rosemarie P Abad
- Chloe Abadi
- Johanna Abadias Gonzalez
- Renante Abagat
- Ida Mae Demayoga Abajon
All providers in Jacksonville, FL · Behavior Technician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.