Healthcare Provider Details

I. General information

NPI: 1992404917
Provider Name (Legal Business Name): CAITLIN KIERNAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13777 BELCHER RD S
LARGO FL
33771-4096
US

IV. Provider business mailing address

535 LOUDEN AVE
DUNEDIN FL
34698-7627
US

V. Phone/Fax

Practice location:
  • Phone: 727-280-6643
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: