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General NPI Number Information
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NPI Number | 1548770118
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Entity Type | Organization
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Legal Business Name | TAYLOR MOBILE MED
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 8647 BETTY ST
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City | PORT RICHEY
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State | FL
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Zip | 34668-6044
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Country | US
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Telephone | 941-777-5159
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Fax | 833-688-7731
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Provider Business Mailing Address
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Address Line | 8647 BETTY ST
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City | PORT RICHEY
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State | FL
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Zip | 34668-6044
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Country | US
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Telephone | 941-777-5159
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Fax | 278-076-8297
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Authorized Official
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Title or Position | OWNER
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Name | LINDY ALLISON TAYLOR
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Credential |
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Telephone | 941-777-5159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME110686
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License Number State | FL
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