1508448804 NPI number — UP BEHAVIOR LLC

Table of content: CAITLIN ALEXANDRA VELA DPT (NPI 1033705298)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508448804 NPI number — UP BEHAVIOR LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UP BEHAVIOR LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508448804
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4417 SE 16TH PL STE 14
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAPE CORAL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33904-7471
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-306-4537
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4417 SE 16TH PL STE 14
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAPE CORAL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33904-7471
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-306-4537
Provider Business Practice Location Address Fax Number:
239-799-7676
Provider Enumeration Date:
04/26/2021

Additional Information

Authorized Official

Authorized Official Last Name:
ALFONSO
Authorized Official First Name:
CYNDIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
786-678-5051

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110240400 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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