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NPI Code Detail

MEDICARE: KATLYN BUSHEY

MEDICARE: KATLYN BUSHEY
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
1390200000XStudent in an Organized Health Care Education/Training Program
2103K00000XBehavior Analyst

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 : 1710339171
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATLYN BUSHEY
Provider Business Mailing Address
First Line : 505 CYPRESS AVE
Second Line :
City : SANFORD
State : FL
Zip : 32771-1956
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4727 W IRLO BRONSON MEMORIAL HWY
Second Line :
City : KISSIMMEE
State : FL
Zip : 34746-5326
Country : US
Telephone Number : 407-978-6085
Fax Number : 321-445-9760
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2016
Last Update Date : 04/03/2025

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Directions to “ KATLYN BUSHEY ” Practice Location

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