Healthcare Provider Details

I. General information

NPI: 1053026021
Provider Name (Legal Business Name): PATRICIA A TAYLOR INDEPENDENT PROVIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26300 EUCLID AVE STE 205
EUCLID OH
44132-3708
US

IV. Provider business mailing address

26300 EUCLID AVE
EUCLID OH
44132-3708
US

V. Phone/Fax

Practice location:
  • Phone: 216-417-0340
  • Fax:
Mailing address:
  • Phone: 440-334-4634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number1832072
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number1832072
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number1832072
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: