Provider Demographics
NPI:1104618925
Name:TAYLOR, RAMIYAH CHANTELL
Entity type:Individual
Prefix:MS
First Name:RAMIYAH
Middle Name:CHANTELL
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:RAMIYAH
Other - Middle Name:CHANTELL
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RAMIYAH
Mailing Address - Street 1:300 INTERNATIONAL PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5028
Mailing Address - Country:US
Mailing Address - Phone:866-610-0580
Mailing Address - Fax:866-611-1558
Practice Address - Street 1:247 SW PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34984-5015
Practice Address - Country:US
Practice Address - Phone:772-207-1356
Practice Address - Fax:772-742-2924
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician