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General NPI Number Information
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NPI Number | 1477185064
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Entity Type | Individual
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Provider Name | STACY ANN TAYLOR
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Gender | Female
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 02/11/2020
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Provider Practice Location Address
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Address Line | 6536 OLD BRICK RD STE 21
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City | WINDERMERE
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State | FL
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Zip | 34786-5841
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Country | US
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Telephone | 305-785-8904
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Fax |
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Provider Business Mailing Address
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Address Line | 11324 CITRA CIR APT 202
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City | WINDERMERE
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State | FL
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Zip | 34786-5950
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Country | US
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Telephone | 305-785-8904
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP3260
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License Number State | FL
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