Healthcare Provider Details

I. General information

NPI: 1427435874
Provider Name (Legal Business Name): DEVON ALLYN WARNER RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E COLONIAL DR
ORLANDO FL
32803
US

IV. Provider business mailing address

500 E COLONIAL DR
ORLANDO FL
32803-4504
US

V. Phone/Fax

Practice location:
  • Phone: 407-218-4340
  • Fax: 407-218-4303
Mailing address:
  • Phone: 407-218-4340
  • Fax: 407-218-4303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-16-19793
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: