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General NPI Number Information
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NPI Number | 1548767718
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Entity Type | Individual
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Provider Name | KYLE FRANK BCBA
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Gender | Male
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 2154 CENTRAL FLORIDA PKWY STE B2
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City | ORLANDO
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State | FL
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Zip | 32837-8986
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Country | US
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Telephone | 612-807-3212
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Fax |
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Provider Business Mailing Address
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Address Line | 1704 ORRINGTON PAYNE PL
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City | CASSELBERRY
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State | FL
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Zip | 32707-9060
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Country | US
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Telephone | 612-807-3212
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-20-42940
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-18-8623
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License Number State | FL
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