Healthcare Provider Details

I. General information

NPI: 1912812140
Provider Name (Legal Business Name): TAYLOR THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5413 BLUE AZURE DR
WIMAUMA FL
33598-4186
US

IV. Provider business mailing address

5413 BLUE AZURE DR
WIMAUMA FL
33598-4186
US

V. Phone/Fax

Practice location:
  • Phone: 941-737-0973
  • Fax:
Mailing address:
  • Phone: 941-737-0973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: