Healthcare Provider Details

I. General information

NPI: 1134035793
Provider Name (Legal Business Name): SYMONE JANAY MCNAB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12315 LAKE UNDERHILL RD
ORLANDO FL
32828-4507
US

IV. Provider business mailing address

12100 STERLING UNIVERSITY LN
ORLANDO FL
32826-2215
US

V. Phone/Fax

Practice location:
  • Phone: 321-972-4039
  • Fax:
Mailing address:
  • Phone: 954-670-6413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2841921
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: