Healthcare Provider Details

I. General information

NPI: 1104750348
Provider Name (Legal Business Name): TAYLOR CUMBESS B.S. E.D. SLP-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 5TH ST SW STE 3
LIVE OAK FL
32064-2239
US

IV. Provider business mailing address

1415 OHIO AVE N UNIT 177
LIVE OAK FL
32064-7960
US

V. Phone/Fax

Practice location:
  • Phone: 386-362-3231
  • Fax:
Mailing address:
  • Phone: 386-362-3231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI8833
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: