Healthcare Provider Details

I. General information

NPI: 1356004238
Provider Name (Legal Business Name): LINDSAY TAYLOR BER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 10/18/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 SW ARCHER RD
GAINESVILLE FL
32608-1134
US

IV. Provider business mailing address

4455 SW 34TH ST APT QQ223
GAINESVILLE FL
32608-6554
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0111
  • Fax:
Mailing address:
  • Phone: 615-430-6334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34215
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: