Healthcare Provider Details

I. General information

NPI: 1053589523
Provider Name (Legal Business Name): PATRICIA MARIE TAYLOR DEVUYST LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2008
Last Update Date: 02/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8195 N MILITARY TRL SUITE E & F
WEST PALM BEACH FL
33410-6307
US

IV. Provider business mailing address

8195 N MILITARY TRL SUITE E & F
WEST PALM BEACH FL
33410-6307
US

V. Phone/Fax

Practice location:
  • Phone: 561-622-7392
  • Fax: 561-622-7355
Mailing address:
  • Phone: 561-622-7392
  • Fax: 561-622-7355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberMA00013750
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: