Provider Demographics
NPI:1033438296
Name:TAYLOR, MICHELLE JEAN (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:JEAN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:JEAN
Other - Last Name:LUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3136 PLAYERS VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-3118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3136 PLAYERS VIEW CIR
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-3118
Practice Address - Country:US
Practice Address - Phone:612-703-2660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS019098207ZC0006X
MN57435207ZC0006X
ALDO.2576207ZC0006X
FLOS13890207ZC0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology