Healthcare Provider Details

I. General information

NPI: 1407552722
Provider Name (Legal Business Name): TAYLOR KRAMER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7331 COLLEGE PKWY STE 300
FORT MYERS FL
33907-5524
US

IV. Provider business mailing address

6821 PALISADES PARK CT STE 1
FORT MYERS FL
33912-7131
US

V. Phone/Fax

Practice location:
  • Phone: 239-337-2003
  • Fax: 239-337-3168
Mailing address:
  • Phone: 239-936-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9117188
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9117188
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: