Healthcare Provider Details

I. General information

NPI: 1073440079
Provider Name (Legal Business Name): TAYLOR TAYLOR MSN, APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WATERMAN WAY
TAVARES FL
32778-5266
US

IV. Provider business mailing address

788 BUTCH CASSIDY LN
EUSTIS FL
32726-5120
US

V. Phone/Fax

Practice location:
  • Phone: 352-253-3333
  • Fax:
Mailing address:
  • Phone: 407-730-1828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN11047291
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: