Healthcare Provider Details

I. General information

NPI: 1669651998
Provider Name (Legal Business Name): JOELLE ELYSE TAYLOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2007
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 N KENDALL DR SUITE 103
MIAMI FL
33176-2144
US

IV. Provider business mailing address

8950 N KENDALL DR SUITE 103
MIAMI FL
33176-2144
US

V. Phone/Fax

Practice location:
  • Phone: 786-497-3850
  • Fax: 786-497-3851
Mailing address:
  • Phone: 786-497-3850
  • Fax: 786-497-3851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberME114530
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number0101247259
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: