Provider Demographics
NPI:1164068425
Name:TAYLOR, SARA ELIZABETH (CPNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ELIZABETH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ELIZABETH
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4321 N MACDILL AVE
Mailing Address - Street 2:STE 407
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6388
Mailing Address - Country:US
Mailing Address - Phone:863-446-2827
Mailing Address - Fax:
Practice Address - Street 1:4321 N MACDILL AVE
Practice Address - Street 2:STE 407
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6388
Practice Address - Country:US
Practice Address - Phone:863-446-2827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN231507363LP0200X
FLAPRN9266299363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics