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NPI Code Detail

MEDICARE: TAYLOR THAMES

MEDICARE: TAYLOR THAMES
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
1106S00000XBehavior Technician
2106S00000XBehavior TechnicianRBT-21-152643FL

Other Identifiers

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

General Provider Information

NPI Number : 1407340235
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR THAMES
Provider Business Mailing Address
First Line : 7075 N HIGHWAY 1
Second Line :
City : COCOA
State : FL
Zip : 32927-5216
Country : US
Telephone Number : 321-888-3020
Fax Number : 661-263-4584
Provider Business Practice Location Address
First Line : 601 S LAKE DESTINY RD STE 350
Second Line :
City : MAITLAND
State : FL
Zip : 32751-7222
Country : US
Telephone Number : 407-618-0493
Fax Number : 855-864-1499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2018
Last Update Date : 04/08/2026

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Directions to “ TAYLOR THAMES ” Practice Location

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