MEDICARE: SHYTE'ASIA LYNNIAH JAMES

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
1	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1083424808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHYTE'ASIA LYNNIAH JAMES

Provider Business Mailing Address
First Line	:	355 N ROSALIND AVE APT 1003
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-2247
Country	:	US
Telephone Number	:	321-386-7684
Fax Number	:

Provider Business Practice Location Address
First Line	:	646 W 8TH ST
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-4375
Country	:	US
Telephone Number	:	407-283-7671
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2025
Last Update Date	:	01/13/2025

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