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General NPI Number Information
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NPI Number | 1639167786
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Entity Type | Individual
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Provider Name | MARIA CONCEPCION L TAYAO MD
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Gender | Female
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 502 N MOBLEY ST
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City | PLANT CITY
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State | FL
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Zip | 33563-2904
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Country | US
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Telephone | 813-341-7450
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Fax | 813-341-7461
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Provider Business Mailing Address
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Address Line | 13110 ELK MOUNTAIN DR
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City | RIVERVIEW
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State | FL
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Zip | 33579-7182
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Country | US
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Telephone | 813-349-7568
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Fax | 813-349-7561
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME80067
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License Number State | FL
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