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NPI Code Detail

MEDICARE: KYRA MCCORMICK

MEDICARE: KYRA MCCORMICK
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 TechnicianOH

General Provider Information

NPI Number : 1063346351
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYRA MCCORMICK
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 866-610-0580
Fax Number : 866-611-1558
Provider Business Practice Location Address
First Line : 1582 N WAGGONER RD STE A
Second Line :
City : BLACKLICK
State : OH
Zip : 43004-8669
Country : US
Telephone Number : 614-344-0419
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2026
Last Update Date : 06/11/2026

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Directions to “ KYRA MCCORMICK ” Practice Location

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