Individual provider Active NPI

Earl Paul Taitt Jr., MD

  • Psychiatry Physician
  • Orlando, FL
National Provider Identifier
1962542282
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME62465 Issued in FL
Practice address
4151 Hunters Park Lane
Suite 100
Orlando, FL 32837-7690
Phone
(407) 856-8830
Fax
(407) 856-8802
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME62465 FL Primary

Addresses

Primary practice location

4151 Hunters Park Lane
Suite 100
Orlando, FL 32837-7690

Mailing address

4151 Hunters Park Lane
Suite 100
Orlando, FL 32837-7690
Phone (407) 856-8830

Other identifiers 1

IdentifierTypeStateIssuer
371312100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Valencia Psychiatry Psychiatry Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290556800000",
    "number": "1962542282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4151 HUNTERS PARK LANE",
            "address_2": "SUITE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328377690",
            "telephone_number": "407-856-8830",
            "fax_number": "407-856-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4151 HUNTERS PARK LANE",
            "address_2": "SUITE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328377690",
            "telephone_number": "407-856-8830",
            "fax_number": "407-856-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAITT",
        "first_name": "EARL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2010-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME62465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371312100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.