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NPI Code Detail

MEDICARE: SAMANTHA KILGORE

MEDICARE: SAMANTHA KILGORE
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
2106E00000XAssistant Behavior Analyst
3103K00000XBehavior Analyst

Other Identifiers

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

General Provider Information

NPI Number : 1750050670
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA KILGORE
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number : 844-854-1116
Fax Number : 305-846-9711
Provider Business Practice Location Address
First Line : 106 BOSTON AVE STE 105
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32701-4711
Country : US
Telephone Number : 844-244-1818
Fax Number : 805-846-9711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2021
Last Update Date : 10/22/2025

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Directions to “ SAMANTHA KILGORE ” Practice Location

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