Healthcare Provider Details

I. General information

NPI: 1962317172
Provider Name (Legal Business Name): ALEXIS TAYLOR CUNHA RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 N HIGHWAY 19A
MOUNT DORA FL
32757-3476
US

IV. Provider business mailing address

3550 N HIGHWAY 19A
MOUNT DORA FL
32757-3476
US

V. Phone/Fax

Practice location:
  • Phone: 407-683-1072
  • Fax:
Mailing address:
  • Phone: 407-683-1072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2832683
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: