Individual provider Active NPI

Tayler Shea O'Halloran

  • Primary Care Nurse Practitioner
  • Coral Springs, FL
National Provider Identifier
1508724501
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
11040699 Issued in FL
Practice address
11658 NW 19TH Dr
Coral Springs, FL 33071-5742
Phone
(954) 551-4883
NPI assigned
Jan 10, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 11040699 FL Primary

Addresses

Primary practice location

11658 NW 19TH Dr
Coral Springs, FL 33071-5742

Mailing address

11658 NW 19TH Dr
Coral Springs, FL 33071-5742
Phone (954) 551-4883

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11040699FLMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1768003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768003200000",
    "number": "1508724501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11658 NW 19TH DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330715742",
            "telephone_number": "954-551-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11658 NW 19TH DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330715742",
            "telephone_number": "954-551-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HALLORAN",
        "first_name": "TAYLER",
        "middle_name": "SHEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-10",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11040699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2026; 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.