Healthcare Provider Details

I. General information

NPI: 1558004416
Provider Name (Legal Business Name): RIKKISHA GILMORE-BYRD DRPH, CHES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 KISSAM CT
BELLE ISLE FL
32809-3587
US

IV. Provider business mailing address

2501 KISSAM CT
BELLE ISLE FL
32809-3587
US

V. Phone/Fax

Practice location:
  • Phone: 321-271-8066
  • Fax:
Mailing address:
  • Phone: 321-271-8066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3435454
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: