Provider Demographics
NPI:1831399567
Name:ACADEMY FOR AUTISM INC.
Entity type:Organization
Organization Name:ACADEMY FOR AUTISM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZULMA
Authorized Official - Middle Name:IVETTE
Authorized Official - Last Name:RIVAS-VETELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-852-9922
Mailing Address - Street 1:11 EAST LANCASTER ROAD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809
Mailing Address - Country:US
Mailing Address - Phone:407-852-9922
Mailing Address - Fax:407-852-9944
Practice Address - Street 1:11 EAST LANCASTER ROAD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809
Practice Address - Country:US
Practice Address - Phone:407-852-9922
Practice Address - Fax:407-852-9944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL224Z00000X, 225X00000X, 235Z00000X
225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890752800Medicaid