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NPI Code Detail

MEDICARE: KAELA ISHMAEL

MEDICARE: KAELA ISHMAEL
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
1103K00000XBehavior Analyst1-22-60916FL
2106S00000XBehavior Technician

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 : 1952951436
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAELA ISHMAEL
Provider Business Mailing Address
First Line : 3302 PARK BRANCH AVE
Second Line :
City : CLERMONT
State : FL
Zip : 34711-7479
Country : US
Telephone Number : 352-978-6218
Fax Number :
Provider Business Practice Location Address
First Line : 17335 PAGONIA DR STE 109
Second Line :
City : CLERMONT
State : FL
Zip : 34711-6011
Country : US
Telephone Number : 407-614-4299
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2019
Last Update Date : 04/15/2023

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Directions to “ KAELA ISHMAEL ” Practice Location

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