Healthcare Provider Details

I. General information

NPI: 1841032422
Provider Name (Legal Business Name): TIFFANY MICHELLE TAYLOR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 03/03/2025
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

YOUR HEALTH ORG. OF FLORIDA 1301 PLANTATION ISLAND DR. UNIT 303B
ST. AUGUSTINE FL
32080
US

IV. Provider business mailing address

SC HOUSE CALLS INC. 111 DOCTORS CIR.
COLUMBIA SC
29203
US

V. Phone/Fax

Practice location:
  • Phone: 800-491-0909
  • Fax:
Mailing address:
  • Phone: 800-491-0909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11036896
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number36463
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: