Healthcare Provider Details

I. General information

NPI: 1255254769
Provider Name (Legal Business Name): URSULA T TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5554 SAN GABRIEL WAY
ORLANDO FL
32837-8714
US

IV. Provider business mailing address

5554 SAN GABRIEL WAY
ORLANDO FL
32837-8714
US

V. Phone/Fax

Practice location:
  • Phone: 407-844-1531
  • Fax:
Mailing address:
  • Phone: 407-844-1531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSS1810
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: