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General NPI Number Information
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NPI Number | 1366986861
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Entity Type | Individual
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Provider Name | TAYLOR A LEARD PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/19/2016
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1132 S 14TH ST
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-2920
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Country | US
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Telephone | 904-432-3061
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Fax | 904-432-3062
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Provider Business Mailing Address
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Address Line | 2675 WINKLER AVE FL 2
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City | FORT MYERS
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State | FL
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Zip | 33901-9342
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Country | US
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Telephone | 877-856-3774
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Fax | 239-599-2612
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 8238
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2563
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9110871
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9112017
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License Number State | FL
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