Healthcare Provider Details

I. General information

NPI: 1912518689
Provider Name (Legal Business Name): ASHLEY PITTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2020
Last Update Date: 08/14/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12702 SCIENCE DR
ORLANDO FL
32826-3016
US

IV. Provider business mailing address

2101 GLENVIEW CT APT 107
WINTER PARK FL
32792-1792
US

V. Phone/Fax

Practice location:
  • Phone: 407-574-2073
  • Fax: 407-965-4263
Mailing address:
  • Phone: 407-595-8244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: