Charra Vanae Taylor

Individual provider Active NPI Developmental Disabilities Clinic/Center · Pahokee, FL

NPI 1215468558 · NPPES record last updated Mar 23, 2021

Key facts

NPI
1215468558
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Disabilities Clinic/Center 261QD1600X
Practice address
8888 Seville St
Pahokee, FL 33476-1609
Phone
(352) 396-4325
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Bridging Waters Together - the Academy for Unique Creatives, Inc Developmental Disabilities Current Accepting new patients
Bridging Waters Together, LLC Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Yes

Addresses

Primary practice location

8888 Seville St
Pahokee, FL 33476-1609

Mailing address

8888 Seville St
Pahokee, FL 33476-1609
Phone (352) 396-4325

Other providers in Pahokee, FL

All providers in Pahokee, FL · Developmental Disabilities Clinic/Center in Florida

Sources for this page

Verify at the official NPI Registry.