Healthcare Provider Details

I. General information

NPI: 1942708045
Provider Name (Legal Business Name): PROF. DYLAN CRAIG MEADOWS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 12/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7552 NAVARRE PKWY
NAVARRE FL
32566-7305
US

IV. Provider business mailing address

3771 STEFANI RD
CANTONMENT FL
32533-7795
US

V. Phone/Fax

Practice location:
  • Phone: 850-939-4190
  • Fax: 850-939-4196
Mailing address:
  • Phone: 850-607-6910
  • Fax: 850-607-6932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-48397
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: