MEDICARE: MAKAYLA ALESE INGRAHAM

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	106S00000X	Behavior Technician		FL

General Provider Information

NPI Number	:	1649138132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKAYLA ALESE INGRAHAM

Provider Business Mailing Address
First Line	:	12276 SAN JOSE BLVD STE 508
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-8618
Country	:	US
Telephone Number	:	904-886-3228
Fax Number	:	904-485-8876

Provider Business Practice Location Address
First Line	:	12276 SAN JOSE BLVD STE 508
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-8618
Country	:	US
Telephone Number	:	904-886-3228
Fax Number	:	904-485-8876

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

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

Similar Medicare Providers

1124986534 — SALEM ISABELLA DERDOCK
Practice Location Address:

12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL
32223-8618

Practice Phone: 904-886-3228
Practice Fax: 904-485-8876

1710844253 — JANELLE YOUNG
Practice Location Address:

12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL
32223-8618

Practice Phone: 904-886-3228
Practice Fax: 904-485-8876

1942226493 — GREAT STRIDES REHABILITATION INC.
Practice Location Address:

12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL
32223-8618

Practice Phone: 904-886-3228
Practice Fax: 904-404-7743

1114094661 — JILL MALISZEWSKI
Practice Location Address:

12276 SAN JOSE BLVD STE 507
JACKSONVILLE, FL
32223-8618

Practice Phone: 904-288-8910
Practice Fax: 904-288-8912

1619044195 — MEGAN FLANIGAN DILLON
Practice Location Address:

12276 SAN JOSE BLVD STE 507
JACKSONVILLE, FL
32223-8618

Practice Phone: 904-288-8910
Practice Fax: 904-288-8912

1457428922 — SARAH GAY
Practice Location Address:

12276 SAN JOSE BLVD STE 507
JACKSONVILLE, FL
32223-8618

Practice Phone: 904-288-8910
Practice Fax: 904-288-8912

Directions to “ MAKAYLA ALESE INGRAHAM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.