MEDICARE: PROF. DYLAN CRAIG MEADOWS

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	RBT-18-48397	FL

General Provider Information

NPI Number	:	1942708045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. DYLAN CRAIG MEADOWS

Provider Business Mailing Address
First Line	:	3771 STEFANI RD
Second Line	:
City	:	CANTONMENT
State	:	FL
Zip	:	32533-7795
Country	:	US
Telephone Number	:	850-607-6910
Fax Number	:	850-607-6932

Provider Business Practice Location Address
First Line	:	7552 NAVARRE PKWY
Second Line	:
City	:	NAVARRE
State	:	FL
Zip	:	32566-7305
Country	:	US
Telephone Number	:	850-939-4190
Fax Number	:	850-939-4196

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

Provider Enumeration Date	:	01/24/2018
Last Update Date	:	12/14/2025

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