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NPI Code Detail

MEDICARE: MADISON O'BRIEN RMHCI

MEDICARE: MADISON O'BRIEN RMHCI
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
1101YM0800XMental Health CounselorIMH26991FL

General Provider Information

NPI Number : 1992668487
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON O'BRIEN RMHCI
Provider Business Mailing Address
First Line : 1307 S INTERNATIONAL PKWY STE 2051
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-1414
Country : US
Telephone Number : 407-284-1191
Fax Number :
Provider Business Practice Location Address
First Line : 1307 S INTERNATIONAL PKWY STE 2051
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-1414
Country : US
Telephone Number : 407-284-1191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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Directions to “ MADISON O'BRIEN RMHCI” Practice Location

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