Healthcare Provider Details

I. General information

NPI: 1386419935
Provider Name (Legal Business Name): MADISON BESSETTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4945 S ORANGE BLOSSOM TRL STE 6
ORLANDO FL
32839-2381
US

IV. Provider business mailing address

724 ENSENADA DR
ORLANDO FL
32825-7912
US

V. Phone/Fax

Practice location:
  • Phone: 407-964-1440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27634
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: