Healthcare Provider Details

I. General information

NPI: 1013690429
Provider Name (Legal Business Name): RYLEIGH NICOLE CAWBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4359 5TH AVE
PACE FL
32571-1828
US

IV. Provider business mailing address

4359 5TH AVE
PACE FL
32571-1828
US

V. Phone/Fax

Practice location:
  • Phone: 850-503-0805
  • Fax:
Mailing address:
  • Phone: 850-503-0805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2857822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: