Healthcare Provider Details

I. General information

NPI: 1841709003
Provider Name (Legal Business Name): CAITLIN MICHELLE GILRANE RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2017
Last Update Date: 07/21/2022
Certification Date: 12/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E COLONIAL DR
ORLANDO FL
32803-4510
US

IV. Provider business mailing address

1509 E COLONIAL DR STE 300
ORLANDO FL
32803-4729
US

V. Phone/Fax

Practice location:
  • Phone: 407-218-4340
  • Fax: 407-218-4303
Mailing address:
  • Phone: 407-218-4371
  • Fax: 407-218-4304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-69711
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: