MEDICARE: PAUL STEVEN TAYLOR

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	183500000X	Pharmacist	PS44506	FL

General Provider Information

NPI Number	:	1205174414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL STEVEN TAYLOR

Provider Business Mailing Address
First Line	:	4849 S MILITARY TRL
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-5310
Country	:	US
Telephone Number	:	561-434-4537
Fax Number	:

Provider Business Practice Location Address
First Line	:	4849 S MILITARY TRL
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-5310
Country	:	US
Telephone Number	:	561-434-4537
Fax Number	:

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

Provider Enumeration Date	:	01/22/2013
Last Update Date	:	01/22/2013

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