Healthcare Provider Details

I. General information

NPI: 1356124390
Provider Name (Legal Business Name): RILEY ELIZABETH KALINOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W UNIVERSITY BLVD
MELBOURNE FL
32901-8995
US

IV. Provider business mailing address

150 W UNIVERSITY BLVD
MELBOURNE FL
32901-8995
US

V. Phone/Fax

Practice location:
  • Phone: 321-674-8000
  • Fax:
Mailing address:
  • Phone: 321-674-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: