Healthcare Provider Details

I. General information

NPI: 1912412891
Provider Name (Legal Business Name): TAYLOR L RICHARDSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2017
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 S FEDERAL HWY
FT LAUDERDALE FL
33316-1245
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 954-315-5784
  • Fax: 954-522-0755
Mailing address:
  • Phone: 954-315-5784
  • Fax: 954-522-0755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN9449825
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: