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General NPI Number Information
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NPI Number | 1790765915
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Entity Type | Individual
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Provider Name | EDWIN EDGARDO TAYLOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 4264 AVALON BLVD
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City | MILTON
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State | FL
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Zip | 32583-2808
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Country | US
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Telephone | 850-626-5381
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Fax | 850-983-8963
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Provider Business Mailing Address
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Address Line | 4264 AVALON BLVD
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City | MILTON
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State | FL
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Zip | 32583-2808
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Country | US
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Telephone | 972-268-9383
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Fax | 972-870-7405
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | MD022947
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME96266
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 48326
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | P9012
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License Number State | TX
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