Healthcare Provider Details

I. General information

NPI: 1144423088
Provider Name (Legal Business Name): JANICE ABIGAIL TAYLOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 10/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 13833
PHILADELPHIA PA
19101-3833
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-8825
  • Fax: 713-500-7296
Mailing address:
  • Phone: 352-273-8825
  • Fax: 713-500-7296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number57006970
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberN6709
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberN6709
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberME116911
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: