MEDICARE: DR. PETER A TAYLOR D.O.

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
1	2085P0229X	Pediatric Radiology Physician	61761	GA
2	2085R0202X	Diagnostic Radiology Physician	036154770	IL
3	2085P0229X	Pediatric Radiology Physician	OS13096	FL
4	2085R0202X	Diagnostic Radiology Physician	DO-05019	IA
5	2085R0202X	Diagnostic Radiology Physician	OS13096	FL
6	2085R0202X	Diagnostic Radiology Physician	2OA8588	CA
7	2085R0204X	Vascular & Interventional Radiology Physician	74036	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184754384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER A TAYLOR D.O.

Provider Business Mailing Address
First Line	:	501 6TH AVE S DEPT OF
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-4634
Country	:	US
Telephone Number	:	727-767-3318
Fax Number	:	727-767-3318

Provider Business Practice Location Address
First Line	:	501 6TH AVE S DEPT OF
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-4634
Country	:	US
Telephone Number	:	727-767-3318
Fax Number	:	727-767-3318

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	03/03/2026

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