Healthcare Provider Details

I. General information

NPI: 1659945988
Provider Name (Legal Business Name): ASHLEY LYNN SANTOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 TURKEY LAKE RD
ORLANDO FL
32819-4200
US

IV. Provider business mailing address

7075 KINGSPOINTE PKWY STE 14
ORLANDO FL
32819-6542
US

V. Phone/Fax

Practice location:
  • Phone: 407-203-3192
  • Fax:
Mailing address:
  • Phone: 321-732-3723
  • Fax: 321-352-7168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-50784
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: