MEDICARE: MR. TERRENCE LYNDELL BRYANT SR. MA, BCBA

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	1-01-0543	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134301237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TERRENCE LYNDELL BRYANT SR. MA, BCBA

Provider Business Mailing Address
First Line	:	4421 OAKHAM CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-8243
Country	:	US
Telephone Number	:	407-461-1910
Fax Number	:	407-297-8870

Provider Business Practice Location Address
First Line	:	7635 ASHLEY PARK CT STE 503
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-6196
Country	:	US
Telephone Number	:	407-461-1910
Fax Number	:	407-297-8870

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

Provider Enumeration Date	:	11/30/2007
Last Update Date	:	05/28/2026

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