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NPI Code Detail

MEDICARE: TAYLOR MOORE DPT

MEDICARE: TAYLOR MOORE DPT
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
1225100000XPhysical Therapist29480FL

General Provider Information

NPI Number : 1992105563
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR MOORE DPT
Provider Business Mailing Address
First Line : 10607 SHELDON RD
Second Line :
City : TAMPA
State : FL
Zip : 33626-5114
Country : US
Telephone Number : 813-792-1531
Fax Number : 813-792-1721
Provider Business Practice Location Address
First Line : 10607 SHELDON RD
Second Line :
City : TAMPA
State : FL
Zip : 33626-5114
Country : US
Telephone Number : 813-792-1531
Fax Number : 813-792-1721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2014
Last Update Date : 01/04/2017

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