Healthcare Provider Details

I. General information

NPI: 1023941150
Provider Name (Legal Business Name): TAYLOR MACKENZIE LUTHRINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 SIMMONS LOOP
RIVERVIEW FL
33578-9498
US

IV. Provider business mailing address

500 KNIGHTS RUN AVE UNIT 815
TAMPA FL
33602-6009
US

V. Phone/Fax

Practice location:
  • Phone: 813-302-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS67570
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: