=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275479461
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAKAYLIN IRENE SIZEMORE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/28/2026
-----------------------------------------------------
Last Update Date | 04/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400 FRANDORSON CIR STE 4234
-----------------------------------------------------
City | APOLLO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33572-2648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-324-5523
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5536 BLUE AZURE DR
-----------------------------------------------------
City | WIMAUMA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33598-4187
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-547-2397
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------