MEDICARE: KYVIANAS INC.

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	251E00000X	Home Health Agency	OT3587	FL

General Provider Information

NPI Number	:	1295775690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KYVIANAS INC.

Provider Business Mailing Address
First Line	:	2625 DIXIE LN
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34744-2794
Country	:	US
Telephone Number	:	407-744-0433
Fax Number	:	407-348-4109

Provider Business Practice Location Address
First Line	:	492 ROYAL PALM DR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34743-9448
Country	:	US
Telephone Number	:	407-414-1608
Fax Number	:	407-348-4109

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	MISS ANA MARIA SANTOS
Credential	:	OTR/L
Telephone Number	:	407-414-1608

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	10/10/2007

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Directions to “KYVIANAS INC. ” Practice Location

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