Healthcare Provider Details

I. General information

NPI: 1083424808
Provider Name (Legal Business Name): SHYTE'ASIA LYNNIAH JAMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 W 8TH ST
LAKELAND FL
33805-4375
US

IV. Provider business mailing address

355 N ROSALIND AVE APT 1003
ORLANDO FL
32801-2247
US

V. Phone/Fax

Practice location:
  • Phone: 407-283-7671
  • Fax:
Mailing address:
  • Phone: 321-386-7684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: