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NPI Code Detail

MEDICARE: TAYLOR MAE TEMNICK EDD, LAT, ATC, CES,

MEDICARE: TAYLOR MAE TEMNICK EDD, LAT, ATC, CES,
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
12255A2300XAthletic TrainerAT1068KY
22255A2300XAthletic TrainerAL5456FL

General Provider Information

NPI Number : 1285042549
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR MAE TEMNICK EDD, LAT, ATC, CES,
Provider Business Mailing Address
First Line : 1745 S HIGHLAND AVE
Second Line :
City : CLEARWATER
State : FL
Zip : 33756-1852
Country : US
Telephone Number : 727-587-0377
Fax Number : 727-548-1360
Provider Business Practice Location Address
First Line : 8900 PARK BLVD
Second Line :
City : SEMINOLE
State : FL
Zip : 33777-4119
Country : US
Telephone Number : 727-545-4545
Fax Number : 727-548-1360
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2014
Last Update Date : 11/07/2022

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