MEDICARE: DR. CANDACE BARRETT

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	103K00000X	Behavior Analyst	1-15-19416	FL

General Provider Information

NPI Number	:	1710820360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CANDACE BARRETT

Provider Business Mailing Address
First Line	:	1500 PARK CENTER DR STE 100
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-5708
Country	:	US
Telephone Number	:	858-382-2775
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 PARK CENTER DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-5704
Country	:	US
Telephone Number	:	858-382-2775
Fax Number	:

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

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/13/2026

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