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General NPI Number Information
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NPI Number | 1821852047
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Entity Type | Organization
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Legal Business Name | DR. TAYLOR D'ANTICO, PT PLLC
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Dates
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Enumeration Date | 02/08/2024
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 871 IBIS WALK PL N UNIT 7304
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City | ST PETERSBURG
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State | FL
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Zip | 33716-3842
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Country | US
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Telephone | 908-868-7538
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Fax |
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Provider Business Mailing Address
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Address Line | 871 IBIS WALK PL N UNIT 7304
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City | ST PETERSBURG
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State | FL
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Zip | 33716-3842
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY
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Name | DR. TAYLOR D'ANTICO
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Credential |
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Telephone | 908-868-7538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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