Healthcare Provider Details

I. General information

NPI: 1558869727
Provider Name (Legal Business Name): TAYLOR HUFF
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2174 62ND ST N
CLEARWATER FL
33760-2500
US

IV. Provider business mailing address

2174 62ND ST N
CLEARWATER FL
33760-2500
US

V. Phone/Fax

Practice location:
  • Phone: 727-742-2577
  • Fax:
Mailing address:
  • Phone: 727-742-2577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number1558869727
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: