MEDICARE: DR. KEIAN HALLS

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	183500000X	Pharmacist	PS69260	FL

General Provider Information

NPI Number	:	1851276877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEIAN HALLS

Provider Business Mailing Address
First Line	:	1750 RUSHDEN DR
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-7708
Country	:	US
Telephone Number	:	407-222-3356
Fax Number	:

Provider Business Practice Location Address
First Line	:	5655 RED BUG LAKE RD
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-5013
Country	:	US
Telephone Number	:	407-695-5814
Fax Number	:

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

Provider Enumeration Date	:	08/08/2025
Last Update Date	:	08/08/2025

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Directions to “ DR. KEIAN HALLS ” Practice Location

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