Provider Demographics
NPI:1598279382
Name:MILTON, JONATHAN (RBT)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:MILTON
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4917 ELI ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-1717
Mailing Address - Country:US
Mailing Address - Phone:407-808-7837
Mailing Address - Fax:407-494-6057
Practice Address - Street 1:500 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4510
Practice Address - Country:US
Practice Address - Phone:407-218-4371
Practice Address - Fax:407-218-4303
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-01
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-18-54683Medicaid