Provider Demographics
NPI:1114275302
Name:TAYLOR, ADRIAN LEIGH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:LEIGH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ADRIAN
Other - Middle Name:LEIGH
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:909 MIRAMAR ST
Mailing Address - Street 2:SUITE B/C
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-9167
Mailing Address - Country:US
Mailing Address - Phone:239-540-7900
Mailing Address - Fax:
Practice Address - Street 1:909 MIRAMAR ST
Practice Address - Street 2:SUITE B/C
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-9167
Practice Address - Country:US
Practice Address - Phone:239-540-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27646225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist