MEDICARE: KALEENA MAYAN

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	235Z00000X	Speech-Language Pathologist	SA22475	FL

General Provider Information

NPI Number	:	1447962717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALEENA MAYAN

Provider Business Mailing Address
First Line	:	5717 SAGO PALM DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7160
Country	:	US
Telephone Number	:	786-301-8958
Fax Number	:

Provider Business Practice Location Address
First Line	:	5717 SAGO PALM DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7160
Country	:	US
Telephone Number	:	786-301-8958
Fax Number	:

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

Provider Enumeration Date	:	12/19/2022
Last Update Date	:	12/05/2024

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Directions to “ KALEENA MAYAN ” Practice Location

Language	Start Address	Practice Location

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