MEDICARE: TAYLOR LAWTON PA-C

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	363A00000X	Physician Assistant	PA9109105	FL

General Provider Information

NPI Number	:	1427428457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR LAWTON PA-C

Provider Business Mailing Address
First Line	:	1007 PROFESSIONAL PARK DR
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-4886
Country	:	US
Telephone Number	:	813-651-3300
Fax Number	:	813-651-4455

Provider Business Practice Location Address
First Line	:	1007 PROFESSIONAL PARK DR
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-4886
Country	:	US
Telephone Number	:	813-651-3300
Fax Number	:	813-651-4455

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

Provider Enumeration Date	:	10/02/2015
Last Update Date	:	10/02/2015

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