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NPI Code Detail

MEDICARE: TAYLOR MARTZ

MEDICARE: TAYLOR MARTZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantPTA 24903FL

General Provider Information

NPI Number : 1063810885
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR MARTZ
Provider Business Mailing Address
First Line : 405 LAKE HOWELL RD STE 1031
Second Line :
City : MAITLAND
State : FL
Zip : 32751-5926
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 405 LAKE HOWELL RD STE 1031
Second Line :
City : MAITLAND
State : FL
Zip : 32751-5926
Country : US
Telephone Number : 407-671-0433
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2014
Last Update Date : 12/10/2014

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Directions to “ TAYLOR MARTZ ” Practice Location

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