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General NPI Number Information
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NPI Number | 1104786862
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Entity Type | Individual
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Provider Name | KALYNN DRAKE
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Gender | Female
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Dates
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Enumeration Date | 11/14/2025
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 779 SW 9TH AVE
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City | MIAMI
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State | FL
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Zip | 33130
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Country | US
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Telephone | 833-210-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 5793 COUNTY ROAD 248
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City | O BRIEN
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State | FL
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Zip | 32071-4148
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Country | US
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Telephone | 833-210-4080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | XXXXXX
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License Number State | FL
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