Healthcare Provider Details

I. General information

NPI: 1912739509
Provider Name (Legal Business Name): TAKAIRA CUYLER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 08/14/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 NE 54TH TERRACE
SUMTERVILLE FL
33521
US

IV. Provider business mailing address

305 HAZEL ST
WILDWOOD FL
34785-4605
US

V. Phone/Fax

Practice location:
  • Phone: 352-689-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11032762
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: