MEDICARE: TGL PRECISION WELLNESS

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	251J00000X	Nursing Care Agency
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1770411647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TGL PRECISION WELLNESS

Provider Business Mailing Address
First Line	:	205 EAGLE HARBOR WAY
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32124-1023
Country	:	US
Telephone Number	:	607-316-7043
Fax Number	:

Provider Business Practice Location Address
First Line	:	1913 N CLYDE MORRIS BLVD STE 120
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-5519
Country	:	US
Telephone Number	:	607-316-7043
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAYANNA LAWLOR
Credential	:	FNP-BC
Telephone Number	:	607-316-7043

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/14/2026

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Directions to “TGL PRECISION WELLNESS ” Practice Location

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