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NPI Code Detail

MEDICARE: GINA DENISE WORKMAN

MEDICARE: GINA DENISE WORKMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043842875
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA DENISE WORKMAN
Provider Business Mailing Address
First Line : 8701 MAITLAND SUMMIT BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32810-5915
Country : US
Telephone Number : 407-347-6114
Fax Number :
Provider Business Practice Location Address
First Line : 1775 W STATE ROAD 434
Second Line :
City : LONGWOOD
State : FL
Zip : 32750-5067
Country : US
Telephone Number : 407-347-6114
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2020
Last Update Date : 03/23/2021

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