Healthcare Provider Details

I. General information

NPI: 1912823584
Provider Name (Legal Business Name): TAYGAN CAPITAL HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14041 HYATT RD APT 3304
JACKSONVILLE FL
32218-2278
US

IV. Provider business mailing address

14041 HYATT RD APT 3304
JACKSONVILLE FL
32218-2278
US

V. Phone/Fax

Practice location:
  • Phone: 904-649-6910
  • Fax: 904-649-6910
Mailing address:
  • Phone: 904-649-6910
  • Fax: 904-649-6910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: NICOLE WILLIE
Title or Position: CEO/OWNER
Credential:
Phone: 904-649-6910