MEDICARE: KARI ANN DINEEN

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
1	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285244699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI ANN DINEEN

Provider Business Mailing Address
First Line	:	300 INTERNATIONAL PKWY STE 200
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5028
Country	:	US
Telephone Number	:	866-610-0580
Fax Number	:

Provider Business Practice Location Address
First Line	:	4085 HANCOCK BRIDGE PKWY
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-7219
Country	:	US
Telephone Number	:	239-677-3767
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2020
Last Update Date	:	09/13/2021

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Directions to “ KARI ANN DINEEN ” Practice Location

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