Provider Demographics
NPI:1114950037
Name:TAYLOR, JEANNA SEYLER (DC)
Entity Type:Individual
Prefix:DR
First Name:JEANNA
Middle Name:SEYLER
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 NE 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-6319
Mailing Address - Country:US
Mailing Address - Phone:352-732-0200
Mailing Address - Fax:352-732-2623
Practice Address - Street 1:801 NE 25TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6319
Practice Address - Country:US
Practice Address - Phone:352-732-0200
Practice Address - Fax:352-732-2623
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381622200Medicaid
FL76971OtherBLUE CROSS BLUE SHIELD
FL76971ZMedicare ID - Type UnspecifiedGROUP NUMER K4309