Provider Demographics
NPI:1174001515
Name:TAYLOR, JASON (ARNP)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-8670
Mailing Address - Country:US
Mailing Address - Phone:352-875-8846
Mailing Address - Fax:
Practice Address - Street 1:6160 SW STATE ROAD 200 # 119
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-8307
Practice Address - Country:US
Practice Address - Phone:352-233-4178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-28
Last Update Date:2018-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9262142363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily