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General NPI Number Information
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NPI Number | 1053903245
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Entity Type | Individual
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Provider Name | TRAVIS TAYLOR APRN, PMHNP
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Gender | Male
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Dates
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Enumeration Date | 02/09/2021
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Last Update Date | 05/31/2026
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Provider Practice Location Address
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Address Line | 8849 HAWBUCK ST STE B
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City | TRINITY
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State | FL
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Zip | 34655-9805
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Country | US
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Telephone | 727-358-9911
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Fax | 727-499-2612
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Provider Business Mailing Address
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Address Line | 8849 HAWBUCK ST STE B
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City | TRINITY
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State | FL
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Zip | 34655-9805
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Country | US
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Telephone | 727-358-9911
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Fax | 727-499-2612
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9543559
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11022346
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License Number State | FL
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