Healthcare Provider Details

I. General information

NPI: 1124326772
Provider Name (Legal Business Name): DAVID F TAYLOR CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2011
Last Update Date: 06/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 SUN N LAKE BLVD
SEBRING FL
33872-1986
US

IV. Provider business mailing address

4519 GEORGE RD STE 100
TAMPA FL
33634-7329
US

V. Phone/Fax

Practice location:
  • Phone: 813-496-1075
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9245404
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9245404
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: