Individual
PAULETTE ANNMARIE ANNIKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 EAGLE DR, KISSIMMEE, FL 34759-4432
(863) 547-4886
(863) 547-4993
Mailing address
415 EAGLE DR, KISSIMMEE, FL 34759-4432
(863) 547-4886
(863) 547-4993
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
692345396
FL
320800000X
Mental Illness Community Based Residential Treatment Facility
692345396
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320600000X
—
FL
05
—
692345396
—
FL
Enumeration date
02/05/2022
Last updated
02/05/2022
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