Healthcare Provider Details

I. General information

NPI: 1508784901
Provider Name (Legal Business Name): ALEXIS MOET TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 BUTTONWOOD LN
BOYNTON BEACH FL
33436-7113
US

IV. Provider business mailing address

506 BUTTONWOOD LN
BOYNTON BEACH FL
33436-7113
US

V. Phone/Fax

Practice location:
  • Phone: 434-882-8225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number9639253
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: