MEDICARE: TAYLOR SUPPORT SERVICES, INC

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	251C00000X	Developmentally Disabled Services Day Training Agency		FL
2	251C00000X	Developmentally Disabled Services Day Training Agency		FL

General Provider Information

NPI Number	:	1669440608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAYLOR SUPPORT SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 21428
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33742-1428
Country	:	US
Telephone Number	:	727-430-8855
Fax Number	:	727-866-8160

Provider Business Practice Location Address
First Line	:	2000 69TH AVE S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33712-5822
Country	:	US
Telephone Number	:	727-430-8855
Fax Number	:	727-866-8160

Authorized Official
Title or Position	:	CEO
Name	:	MARIA ELANA TAYLOR
Credential	:	BA
Telephone Number	:	727-430-8855

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	08/22/2020

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