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NPI Code Detail

MEDICARE: MS. KRISLYNN SMITH

MEDICARE: MS. KRISLYNN SMITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1154824027
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISLYNN SMITH
Provider Business Mailing Address
First Line : 6831 LIMPKIN DR
Second Line :
City : ORLANDO
State : FL
Zip : 32810-6080
Country : US
Telephone Number : 407-256-4872
Fax Number :
Provider Business Practice Location Address
First Line : 1227 FLOWERS POINTE LN
Second Line :
City : ORLANDO
State : FL
Zip : 32825-5520
Country : US
Telephone Number : 407-256-4872
Fax Number : 407-264-6482
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2018
Last Update Date : 03/16/2018

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