MEDICARE: TAYLOR KILPATRICK

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
1	1041C0700X	Clinical Social Worker	ISW22855	FL

General Provider Information

NPI Number	:	1619831229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR KILPATRICK

Provider Business Mailing Address
First Line	:	656 EMERALD LAKE DR
Second Line	:
City	:	COCOA
State	:	FL
Zip	:	32926-4674
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3270 SUNTREE BLVD STE 103A
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32940-7540
Country	:	US
Telephone Number	:	321-757-4015
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “ TAYLOR KILPATRICK ” Practice Location

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