=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922989201
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OLIKANO WELLNESS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2025
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 855 OUTER RD
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32814-6652
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-783-9785
-----------------------------------------------------
Fax | 407-556-9524
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 855 OUTER RD
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32814-6652
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-783-9785
-----------------------------------------------------
Fax | 407-556-9524
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MS. INES KORNELIA TAYLOR
-----------------------------------------------------
Credential | FNP/ARNP
-----------------------------------------------------
Telephone | 407-725-0516
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------