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NPI Code Detail

MEDICARE: TAYLOR SHUGA

MEDICARE: TAYLOR SHUGA
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
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669936084
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR SHUGA
Provider Business Mailing Address
First Line : 2035 SW 75TH ST STE B
Second Line :
City : GAINESVILLE
State : FL
Zip : 32607-3425
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4817 EHRLICH RD
Second Line :
City : TAMPA
State : FL
Zip : 33624-2037
Country : US
Telephone Number : 352-332-8588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2019
Last Update Date : 01/30/2019

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TAMPA, FL
33624-2037
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1124583455 — TAYLOR ROTH
Practice Location Address:
4817 EHRLICH RD
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33624-2037
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Practice Fax:
1174187561 — ERICA WENDLING
Practice Location Address:
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33624-2037
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Practice Fax:

Directions to “ TAYLOR SHUGA ” Practice Location

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