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NPI Code Detail

MEDICARE: BENJAMIN TAYLOR JR.

MEDICARE: BENJAMIN TAYLOR JR.
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
1106S00000XBehavior TechnicianFL

General Provider Information

NPI Number : 1376413732
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN TAYLOR JR.
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 866-610-0580
Fax Number :
Provider Business Practice Location Address
First Line : 17335 PAGONIA RD 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 : 11/10/2025
Last Update Date : 12/26/2025

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