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NPI Code Detail

MEDICARE: PAYTON GRAY

MEDICARE: PAYTON GRAY
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

General Provider Information

NPI Number : 1598604472
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAYTON GRAY
Provider Business Mailing Address
First Line : 1239 E NEWPORT CENTER DR STE 101
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33442-7711
Country : US
Telephone Number : 754-341-2745
Fax Number :
Provider Business Practice Location Address
First Line : 6200 LEE VISTA BLVD STE 700
Second Line :
City : ORLANDO
State : FL
Zip : 32822-5150
Country : US
Telephone Number : 321-352-4819
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2026
Last Update Date : 03/26/2026

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Directions to “ PAYTON GRAY ” Practice Location

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