Healthcare Provider Details

I. General information

NPI: 1932846508
Provider Name (Legal Business Name): TAYLOR LEE CARPENTER- BANTEL BT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 W STATE ROAD 434
LONGWOOD FL
32750-5067
US

IV. Provider business mailing address

2301 MAITLAND CENTER PKWY STE 240
MAITLAND FL
32751-7415
US

V. Phone/Fax

Practice location:
  • Phone: 407-919-6845
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: