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General NPI Number Information
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NPI Number | 1275501678
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Entity Type | Organization
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Legal Business Name | THOMAS M. TAYLOR, MD PA
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 3214 W TAMPA BAY BLVD
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City | TAMPA
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State | FL
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Zip | 33607-6616
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Country | US
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Telephone | 813-440-2462
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Fax | 813-877-6556
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Provider Business Mailing Address
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Address Line | PO BOX 4769
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City | TAMPA
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State | FL
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Zip | 33677-4769
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Country | US
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Telephone | 813-440-2462
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Fax | 813-877-6556
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. THOMAS M TAYLOR
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Credential | MD
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Telephone | 813-440-2462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0064670
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License Number State | FL
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