Healthcare Provider Details

I. General information

NPI: 1801707963
Provider Name (Legal Business Name): MADISON LEMONS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MADI LEMONS

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 RADCLYFFE RD
ORLANDO FL
32804-4824
US

IV. Provider business mailing address

1329 RADCLYFFE RD
ORLANDO FL
32804-4824
US

V. Phone/Fax

Practice location:
  • Phone: 224-358-5167
  • Fax:
Mailing address:
  • Phone: 224-358-5167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: