MEDICARE: LATONDA DENICE TAYLOR BSW

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1437002730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATONDA DENICE TAYLOR BSW

Provider Business Mailing Address
First Line	:	715 W RUBY ST
Second Line	:
City	:	TAVARES
State	:	FL
Zip	:	32778-3730
Country	:	US
Telephone Number	:	352-406-1318
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 DOCTORS CT
Second Line	:
City	:	LEESBURG
State	:	FL
Zip	:	34748-7366
Country	:	US
Telephone Number	:	352-327-4417
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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