MEDICARE: KALEAH EDWARDS

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	1-25-82617	FL

General Provider Information

NPI Number	:	1487240123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALEAH EDWARDS

Provider Business Mailing Address
First Line	:	2931 NW 68TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1342
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2931 NW 68TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1342
Country	:	US
Telephone Number	:	561-590-2397
Fax Number	:

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

Provider Enumeration Date	:	12/16/2020
Last Update Date	:	06/30/2026

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Directions to “ KALEAH EDWARDS ” Practice Location

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