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General NPI Number Information
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NPI Number | 1174319420
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Entity Type | Individual
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Provider Name | TAYLOR WOLF RD
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Gender | Female
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 3308 KILMER DR
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City | LAKELAND
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State | FL
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Zip | 33803-4201
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Country | US
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Telephone | 863-225-1660
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Fax |
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Provider Business Mailing Address
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Address Line | 3308 KILMER DR
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City | LAKELAND
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State | FL
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Zip | 33803-4201
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Country | US
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Telephone | 863-225-1660
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Fax |
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | ND8533
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number | ND8533
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number | ND8533
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number | ND8533
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License Number State | FL
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