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General NPI Number Information
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NPI Number | 1295183945
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Entity Type | Individual
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Provider Name | NATHAN TAYLOR D.M.D
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Gender | Male
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 1100 N ALAFAYA TRL
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City | ORLANDO
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State | FL
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Zip | 32828-5966
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Country | US
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Telephone | 321-247-3902
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Fax |
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Provider Business Mailing Address
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Address Line | 1808 NW 137TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2612
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN21825
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License Number State | FL
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