Samantha Vaughan
Individual provider Active NPI Behavior Technician · Sumterville, FL
NPI 1124694757 · NPPES record last updated Mar 24, 2026
Key facts
- NPI
- 1124694757
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-21-165843 (FL)
- Practice address
- 2210 CR 528
Sumterville, FL 33585-5214 - Phone
- (352) 314-3760
- Fax
- (352) 314-3760
- NPI assigned
- Jun 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-21-165843 | FL | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician |
106S00000X | RBT-21-165843 | FL | Yes |
Addresses
Primary practice location
2210 CR 528
Sumterville, FL 33585-5214
Mailing address
1650 W Main St Ste 1
Leesburg, FL 34748-2842
Phone (352) 314-3760
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110277500 | Medicaid | FL |
Other names
- Samantha Elliott
Other providers in Sumterville, FL
- Sumter Pediatrics PA
- Billie Sweeney
- David Thao
- Kathy Brown Thompson
- June E. Tickle
- Julie A Vavruska
- Kristen Venable
- Stephen G Vernon
- Katherine West-Thompson
- Taylor Joshua Wilson
All providers in Sumterville, FL · Behavior Technician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.