MEDICARE: LATEISHA GILZEAN

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	1-17-26697	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1932513389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATEISHA GILZEAN

Provider Business Mailing Address
First Line	:	2314 PESARO CIR
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-5005
Country	:	US
Telephone Number	:	407-601-0491
Fax Number	:	407-395-3487

Provider Business Practice Location Address
First Line	:	3099 ORANGE CENTER BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32805-4362
Country	:	US
Telephone Number	:	407-601-0491
Fax Number	:	407-395-3487

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

Provider Enumeration Date	:	06/13/2014
Last Update Date	:	05/15/2026

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Directions to “ LATEISHA GILZEAN ” Practice Location

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