Provider Demographics
NPI:1518640879
Name:SYLVESTER, KAYLIN
Entity Type:Individual
Prefix:
First Name:KAYLIN
Middle Name:
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 HENDERSON BLVD STE 605C
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5040
Mailing Address - Country:US
Mailing Address - Phone:813-461-5380
Mailing Address - Fax:813-642-4502
Practice Address - Street 1:3825 HENDERSON BLVD STE 605C
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5040
Practice Address - Country:US
Practice Address - Phone:813-461-5380
Practice Address - Fax:813-642-4502
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
FLRBT-23-289550106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician