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General NPI Number Information
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NPI Number | 1376836262
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Entity Type | Individual
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Provider Name | DR. MINDY TAYLOR
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Gender | Female
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Dates
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Enumeration Date | 05/25/2011
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Last Update Date | 10/21/2015
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Provider Practice Location Address
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Address Line | 5535 S WILLIAMSON BLVD SUITE 727
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City | PORT ORANGE
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State | FL
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Zip | 32128-8311
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Country | US
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Telephone | 386-506-8701
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Fax | 386-265-0577
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Provider Business Mailing Address
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Address Line | 5535 S WILLIAMSON BLVD SUITE 727
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City | PORT ORANGE
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State | FL
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Zip | 32128-8311
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Country | US
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Telephone | 386-506-8701
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | PO3493
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License Number State | FL
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