MEDICARE: MR. TAYLOR J MAGRI

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1437787199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TAYLOR J MAGRI

Provider Business Mailing Address
First Line	:	58 NE 14TH ST APT 2622
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33132-1472
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	58 NE 14TH ST APT 2622
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33132-1472
Country	:	US
Telephone Number	:	954-778-3655
Fax Number	:

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

Provider Enumeration Date	:	03/30/2020
Last Update Date	:	03/30/2020

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