Ta Taylor Enterprises, Inc

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

ME92674 Issued in FL

Legal business name

TA TAYLOR ENTERPRISES, INC

Practice address

3046 Del Prado Blvd S
Suite 1a
Cape Coral, FL 33904-7221

Phone

(239) 540-9918

Fax

(239) 540-9192

NPI assigned

Jul 25, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Terese Ann Taylor, M.D.

Title

President

Phone

(239) 540-9918

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280707200000",
    "number": "1124040241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3046 DEL PRADO BLVD S",
            "address_2": "SUITE 1A",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339047221",
            "telephone_number": "239-540-9918",
            "fax_number": "239-540-9192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3046 DEL PRADO BLVD S",
            "address_2": "SUITE 1A",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339047221",
            "telephone_number": "239-540-9918",
            "fax_number": "239-540-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TA TAYLOR ENTERPRISES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-08-02",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "TERESE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-540-9918",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME92674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272932600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.